Jim Tanner

Primary specialty

CounselorTaxonomy code 101Y00000X

Practice address

503 N Main St Ste 539
Pueblo, CO 81003-3133

Phone

(719) 766-9299

NPI assigned

Jun 23, 2022

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Mental Health Counselor

Education

Other, 2019

Medicare assignment

May accept Medicare assignment

Telehealth

Offers telehealth services

Group practices

A New Leaf Therapy PLLCGroup PAC ID 8628346582, 12 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• A New Leaf Therapy, PLLC

  • Community/Behavioral Health Agency
  • Pueblo, CO
  • NPI 1194111500
  Medicare reassignment Care Compare group NPD
• The Next Right Choice LTD

  • Counselor
  • Pueblo, CO
  • NPI 1558089722
  NPD
• A New Leaf Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Pueblo, CO
  • NPI 1598469132
  NPD (past)
• A New Leaf Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Pueblo, CO
  • NPI 1811691447
  NPD (past)
• A New Leaf Therapy, LLC

  • Multi-Specialty Clinic/Center
  • Pueblo, CO
  • NPI 1952006983
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1655942400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1655942400000",
    "number": "1023749629",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "503 N MAIN ST STE 539",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033133",
            "telephone_number": "719-766-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "503 N MAIN ST STE 539",
            "city": "PUEBLO",
            "state": "CO",
            "postal_code": "810033133",
            "telephone_number": "719-766-9299"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JIM",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-06-23",
        "last_updated": "2022-06-23",
        "certification_date": "2022-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talk and Play Therapies LLC
• Lindsey Ann Tallakson, RD, CNSC
• Shan Tandon, M.D.
• Alvin Si-Long Tang, CNM, WHNP-BC
• James Dongbo Tang, M.D.
• Felicia Tapia
• Alla Tasco-Scott, R.M.T.
• Mia Renee Tatman, RRT, RRT-ACCS
• Diane Noriko Tatsuyama, CCC-SLP
• Jed Jitsugo Tatsuyama, MD

• Counselor in Pueblo, CO
• Providers in Pueblo, CO by specialty
• Counselor in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.