Individual provider Active NPI

Tanner Niemann

  • Intermediate Emergency Medical Technician
  • Mendota Heights, MN
National Provider Identifier
1053244558
Registry record updated Jun 4, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intermediate Emergency Medical TechnicianTaxonomy code 146M00000X
Practice address
2520 Pilot Knob Rd Ste 250
Mendota Heights, MN 55120-1347
Phone
(651) 224-8264
NPI assigned
Jun 4, 2026
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 4, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intermediate Emergency Medical Technician 146M00000X Primary

Addresses

Primary practice location

2520 Pilot Knob Rd Ste 250
Mendota Heights, MN 55120-1347

Mailing address

6480 153Rd Way NW
Ramsey, MN 55303-4402
Phone (612) 432-6155

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

NPI Registry JSON

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

{
    "created_epoch": "1780531200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1780531200000",
    "number": "1053244558",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6480 153RD WAY NW",
            "city": "RAMSEY",
            "state": "MN",
            "postal_code": "553034402",
            "telephone_number": "612-432-6155"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2520 PILOT KNOB RD STE 250",
            "city": "MENDOTA HEIGHTS",
            "state": "MN",
            "postal_code": "551201347",
            "telephone_number": "651-224-8264"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIEMANN",
        "first_name": "TANNER",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2026-06-04",
        "last_updated": "2026-06-04",
        "certification_date": "2026-06-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "146M00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medical Technician, Intermediate",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mendota Heights, MN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 4, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.