Active NPI
Tanner Dean Forrest, ATC
- Athletic Trainer
- Fort Scott, KS
National Provider Identifier
1154885556
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 2108 Horton St
Fort Scott, KS 66701-3141 - Phone
- (620) 704-0888
- NPI assigned
- Jan 30, 2019
- Last updated
- May 30, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
2108 Horton St
Fort Scott, KS 66701-3141
Mailing address
709 N Cayuga St
Frontenac, KS 66763-2072
Phone (620) 704-0888
Other practice location 1
609 E Cherry St
Room 160
Springfield, MO 65807-6580
Phone (620) 704-0888
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": "1548806400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1559174400000",
"number": "1154885556",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "709 N CAYUGA ST",
"city": "FRONTENAC",
"state": "KS",
"postal_code": "667632072",
"telephone_number": "620-704-0888"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2108 HORTON ST",
"city": "FORT SCOTT",
"state": "KS",
"postal_code": "667013141",
"telephone_number": "620-704-0888"
}
],
"practiceLocations": [
{
"address_1": "609 E Cherry St",
"address_2": "Room 160",
"address_purpose": "LOCATION",
"city": "Springfield",
"state": "MO",
"postal_code": "658076580",
"country_code": "US",
"telephone_number": "620-704-0888",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORREST",
"first_name": "TANNER",
"middle_name": "DEAN",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-01-30",
"last_updated": "2019-05-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Fort Scott, KS
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.