Individual provider Active NPI

Jon M Tanner, D.C.

  • Rehabilitation Chiropractor
  • Scottsdale, AZ
National Provider Identifier
1033271432
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rehabilitation ChiropractorTaxonomy code 111NR0400X
License
5571 Issued in AZ
Practice address
34597 N 60TH St
Scottsdale, AZ 85262-5240
Phone
(480) 595-6100
Fax
(480) 595-6102
NPI assigned
Dec 14, 2006
Last updated
Jul 8, 2007By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Rehabilitation Chiropractor 111NR0400X 5571 AZ Primary

Addresses

Primary practice location

34597 N 60TH St
Scottsdale, AZ 85262-5240

Mailing address

7397 E Hanover Way
Scottsdale, AZ 85255-6122
Phone (480) 595-6100

Other identifiers 1

IdentifierTypeStateIssuer
AZ0244760OtherAZBLUE CROSS BLUE SHIELD

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20101230000112 AZ Practitioner - ChiropracticPractitioner - Other (Physician) 4486742020 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - West Sunnyvale, 1996
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

33755 N Scottsdale Rd
Suite 101
Scottsdale, AZ 85266-1567
Phone (480) 595-6100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5571AZMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Dr Jon Tanner Chiropractic and Acupuncture LLC CurrentSince Mar 30, 2017 Accepting new patients
Advanced Pain Clinic LLC CurrentSince Sep 17, 2011 Accepting new patients

Locations

33755 N Scottsdale Rd
Ste 101
Scottsdale, AZ 85266
Phone (480) 381-7180

Organizations & group practices 3

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

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1033271432",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7397 E HANOVER WAY",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852556122",
            "telephone_number": "480-595-6100",
            "fax_number": "480-595-6102"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34597 N 60TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852625240",
            "telephone_number": "480-595-6100",
            "fax_number": "480-595-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JON",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "5571",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0244760",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsdale, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.