Shannan M. Tarrer, M.D.

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME106553 Issued in FL

Practice address

800 Prudential Dr
Jacksonville, FL 32207-8202

Phone

(904) 396-5682

Fax

(904) 346-0864

NPI assigned

Dec 29, 2005

Last updated

May 6, 2019By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Merit-based Incentive Payment System (MIPS)

Final score

100 of 100Reported as group

Promoting interoperability

98

Improvement activities

40

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Emergency Physicians Inc

  dba Emergency Resources Group

  • Emergency Medicine Physician
  • Jacksonville, FL
  • NPI 1285686675
  Medicare reassignment NPD
• Emergency Physicians Inc

  dba Emergency Resource Group

  • Emergency Medicine Physician
  • Brunswick, GA
  • NPI 1477001972
  NPD
• Island Emergency Medical Services, P.C.

  • Emergency Medicine Physician
  • Far Rockaway, NY
  • NPI 1639160385
  NPD (past)
• LH Emergency Medical Services PC

  • Emergency Medicine Physician
  • New York, NY
  • NPI 1154379808
  NPD (past)

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

{
    "created_epoch": "1135814400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557100800000",
    "number": "1205813326",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "820 PRUDENTIAL DR STE 713",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078209",
            "telephone_number": "904-396-5682",
            "fax_number": "904-346-0864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 PRUDENTIAL DR",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322078202",
            "telephone_number": "904-396-5682",
            "fax_number": "904-346-0864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARRER",
        "first_name": "SHANNAN",
        "middle_name": "M.",
        "credential": "M.D.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2005-12-29",
        "last_updated": "2019-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME106553",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002096200",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kristi Lynn Tardif, PA-C
• Carmela Lydia Tardo, MD
• Heather Lea Tarno, ARNP
• Jamie Tarpley
• Milta Tarrant
• Rebecca Tarris
• Nicole Danielle Tartal
• Shane Randall Tartt, MD
• Candra Tarver
• Willean Tarver

• Emergency Medicine Physician in Jacksonville, FL
• Providers in Jacksonville, FL by specialty
• Emergency Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 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.
• 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.