Tanner Lightbourne, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

4229 Issued in MT

Practice address

610 California Ave
Libby, MT 59923-1902

Phone

(406) 293-6236

NPI assigned

Jun 29, 2021

Sex

Male

Sole proprietor

No

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 MT

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Specialty

Optometry

Education

Other, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Northwest Family Eye Care

  • Optometrist
  • Libby, MT
  • NPI 1407520562
  Medicare reassignment NPD Authorized official
• Patrick-Purdy Inc

  • Optometrist
  • Libby, MT
  • NPI 1215066188
  NPD

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

{
    "created_epoch": "1624924800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1626048000000",
    "number": "1164092425",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "610 CALIFORNIA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599231902",
            "telephone_number": "406-293-6236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "610 CALIFORNIA AVE",
            "city": "LIBBY",
            "state": "MT",
            "postal_code": "599231902",
            "telephone_number": "406-293-6236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIGHTBOURNE",
        "first_name": "TANNER",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-29",
        "last_updated": "2021-07-12",
        "certification_date": "2021-07-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "MT",
            "license": "4229",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Libby Healthcare LLC
• Libby of Cascadia, LLC
• Libby Schools
• Libby Volunteer Ambulance Service Inc
• Libby'S Lodge of Love LLC
• Lincare Inc
• Lincoln County Community Health Center Inc
• Lincoln County Community Health Center Inc
• Lincoln County Community Health Center, Inc
• Lincoln County Community Health Center, Inc

• Optometrist in Libby, MT
• Providers in Libby, MT by specialty
• Optometrist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 12, 2021; 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.