Madelyn A Tanner, APRN
Individual provider Active NPI Nurse Practitioner · Axson, GA
NPI 1225907967 · NPPES record last updated Dec 26, 2025
Key facts
- NPI
- 1225907967
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Nurse Practitioner 363L00000X
- License
- APRN-NP312186 (GA)
- Practice address
- 7212 Ga Highway 64 E
Axson, GA 31624-2005 - Phone
- (912) 850-9968
- NPI assigned
- Oct 31, 2025
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2025
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
2012 Ocilla Rd
Douglas, GA 31533-2230
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20260429001391 | GA | Practitioner - Nurse Practitioner | 2264909092 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| APRN-NP312186 | GA | MD | Nurse Practitioner |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | APRN-NP312186 | GA | Yes |
Addresses
Primary practice location
7212 Ga Highway 64 E
Axson, GA 31624-2005
Mailing address
7212 Ga Highway 64 E
Axson, GA 31624-2005
Phone (912) 850-9968
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| F08250036 | Other | GA | CERTIFICATION |
Other providers in Axson, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Dec 26, 2025. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.