Jacob Tanner, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

2305211376 Issued in VA

Practice address

1111 Corporate Park Dr Ste B
Forest, VA 24551-2279

Phone

(434) 525-4851

NPI assigned

Aug 4, 2017

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 VA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

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.

• Jasper Rehab VA LLC

  • Physical Therapist
  • Virginia Beach, VA
  • NPI 1073390019
  Medicare reassignment NPD

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

{
    "created_epoch": "1501804800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1245755875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1111 CORPORATE PARK DR STE B",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512279",
            "telephone_number": "434-525-4851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1111 CORPORATE PARK DR STE B",
            "city": "FOREST",
            "state": "VA",
            "postal_code": "245512279",
            "telephone_number": "434-525-4851"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JACOB",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-04",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "VA",
            "license": "2305211376",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Surgery Center of Central Virginia Inc.
• Susan K Roehrich LLC
• Charles Turpin Swartz, DDS
• Lisa Swezey, NP
• Kyle Swim, OTR/L
• Tanzar Chiropractic Wellcare Center
• Jeffrey S Tanzar, D.C.
• Lisa Block Tharpe
• The Dizzy PT
• The Forest Pharmacy Inc

• Physical Therapist in Forest, VA
• Providers in Forest, VA by specialty
• Physical Therapist in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.