John R Tanner, OD

Primary specialty

OptometristTaxonomy code 152W00000X

License

1935 Issued in AZ

Practice address

18431 N 91St Ave
Suite 1
Peoria, AZ 85382-0817

Phone

(623) 933-6586

Fax

(623) 933-9320

NPI assigned

Jun 27, 2005

Last updated

Sep 30, 2014By the provider in NPPES

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 AZ

Eligible to order & refer

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

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• John R Tanner OD PLLC

  • Optometrist
  • Peoria, AZ
  • NPI 1437582152
  Medicare reassignment Authorized official
• Deschamps Eye Care PC

  • Ophthalmology Physician
  • Merrillville, IN
  • NPI 1700950920
  NPD (past)

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

{
    "created_epoch": "1119830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1412035200000",
    "number": "1255337911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE",
            "address_2": "SUITE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-933-6586",
            "fax_number": "623-933-9320"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "18431 N 91ST AVE",
            "address_2": "SUITE 1",
            "city": "PEORIA",
            "state": "AZ",
            "postal_code": "853820817",
            "telephone_number": "623-933-6586",
            "fax_number": "623-933-9320"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JOHN",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-27",
        "last_updated": "2014-09-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "AZ",
            "license": "1935",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Talk the Talk Pediatric Therapy
• Shobhana Talukdar, M.D.
• Bianca Tamas, LICENSEE
• Joanne Tang, OD
• Rebecca A Taniel, LPC, LISAC
• Artthapol Tanphaichitr, MD
• Ricardo Efrain Tapia, M.D
• Tara Ransdell OD PLLC
• Joseph Tarantino, ATC
• Cindy Lou Tatum-Shipley, LCSW

• Optometrist in Peoria, AZ
• Providers in Peoria, AZ by specialty
• Optometrist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 30, 2014; 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.