Jack Ellis Tanner, RPHR

Primary specialty

PharmacistTaxonomy code 183500000X

License

013950 Issued in GA

Practice address

1206 Crawford St
Americus, GA 31709-3277

Phone

(229) 931-0271

Fax

(229) 931-9864

NPI assigned

Oct 6, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Mr. Jack Ellis Tanner Professional name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1160092800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1215024864",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 285",
            "address_2": "122 WEST COLLEGE ST",
            "city": "ELLAVILLE",
            "state": "GA",
            "postal_code": "318060285",
            "telephone_number": "229-937-9105",
            "fax_number": "229-931-9864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1206 CRAWFORD ST",
            "city": "AMERICUS",
            "state": "GA",
            "postal_code": "317093277",
            "telephone_number": "229-931-0271",
            "fax_number": "229-931-9864"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JACK",
        "middle_name": "ELLIS",
        "name_prefix": "Mr.",
        "credential": "RPHR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-10-06",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "GA",
            "license": "013950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACK",
            "last_name": "TANNER",
            "middle_name": "ELLIS",
            "prefix": "MR.",
            "credential": "RPH",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

• Lateshia R Sweet
• Swga Foot & Ankle Center
• Lynette Marie Talley, CNM
• Grace Madrazo Tan, NP-C
• Contessa Tanner-Jones
• Summer N Tanner
• Jeffrey Tarver
• Andrea Tatum
• Christopher Tatum
• Phylicia Taylor

• Pharmacist in Americus, GA
• Providers in Americus, GA by specialty
• Pharmacist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.