Tanner Lee Frey, PHYSICIAN ASSISTANT

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

10931513-1206 Issued in UT

Practice address

1034 N 500 W
Provo, UT 84604-3380

Phone

(801) 358-1076

NPI assigned

Jul 19, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TX, AZ2 enrollments

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

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.

• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Phoenix, AZ
  • NPI 1083643738

  TX

  Medicare reassignment NPD
• Exceptional Physicians Group Arizona PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Maricopa, AZ
  • NPI 1447910229
  Medicare reassignment
• Exceptional Physicians Group Bullhead City Hospital PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Bullhead City, AZ
  • NPI 1518732023
  Medicare reassignment
• Exceptional Physicians Group Prescott Hospital PLLC

  • Emergency Medical Services (Emergency Medicine) Physician
  • Prescott, AZ
  • NPI 1720807670
  Medicare reassignment
• Exceptional Physicians Group Yuma Hospital PLLC

  • Emergency Medicine Physician
  • Yuma, AZ
  • NPI 1235857699
  Medicare reassignment
• Tec Emergency Physicians of Arizona, LLC

  • Emergency Care Clinic/Center
  • Gilbert, AZ
  • NPI 1245772870
  Medicare reassignment
• Dhew Ind HLTH SV HLTH SVS & MNTL HLTH Adm

  • Public Health or Welfare Agency
  • Maricopa, AZ
  • NPI 1538043443
  NPD
• Exceptional Health Care Bullhead City LLC

  • Special Hospital
  • Bullhead City, AZ
  • NPI 1750092110
  NPD (past)
• Exceptional Health Care Prescott LLC

  • Special Hospital
  • Prescott, AZ
  • NPI 1396452108
  NPD (past)

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

{
    "created_epoch": "1531958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562976000000",
    "number": "1164909479",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "245 W 500 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840421302",
            "telephone_number": "801-358-1076"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1034 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043380",
            "telephone_number": "801-358-1076"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FREY",
        "first_name": "TANNER",
        "middle_name": "LEE",
        "name_prefix": "Mr.",
        "credential": "PHYSICIAN ASSISTANT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-19",
        "last_updated": "2019-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207PE0004X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine, Emergency Medical Services",
            "state": "UT",
            "license": "1153249",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "10931513-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rachel Oswald Freeman
• Emily Freeze
• Elizabeth Frei
• Natassja Michelle French
• Stephanie Michelle French, MS-SLP
• Kimberly Anne Friess, MSWI
• Joshua L Fringer
• John K Frischknecht, MD
• Ashley Fritts, PT
• Melissa Nicole Frixione, LAT, ATC

• Physician Assistant in Provo, UT
• Providers in Provo, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.