NPIMap

Individual provider Active NPI

Anthony T Tanner

  • Nurse Practitioner
  • Hurley, MS
National Provider Identifier
1275804270
Registry record updated Apr 12, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
R205397-4 Issued in MN
Practice address
7001 Hwy 614
Hurley, MS 39555
Phone
(228) 588-2938
Fax
(228) 588-9399
NPI assigned
Jan 23, 2012
Last updated
Apr 12, 2020By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 12, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X R205397-4 MN Primary

Addresses

Primary practice location

7001 Hwy 614
Hurley, MS 39555

Mailing address

PO Box 850
Hurley, MS 39555-0850
Phone (228) 588-2938

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20130723000319 MS Practitioner - Nurse Practitioner 4385805100 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2011
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Memorial Hospital at GulfportGroup PAC ID 2466524012, 473 clinicians

Practice addresses (Care Compare)

1340 Broad Ave
Gulfport, MS 39501-2460

3616 Hospital St
Pascagoula, MS 39581-4117
Phone (228) 762-1002

4603 Hospital St
Pascagoula, MS 39581-5337
Phone (228) 822-6040

8006 Hwy 613
Moss Point, MS 39562-8200
Phone (228) 475-1166

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
R205397-4MNMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Singing River Gulfport CurrentSince Jan 15, 2022 Accepting new patients
Singing River Health System CurrentSince Apr 3, 2013 Accepting new patients
Memorial Hospital at Gulfport Nurse Practitioner CurrentSince May 26, 2025 Accepting new patients
Memorial Hospital at Gulfport Current Accepting new patients
Singing River Gulfport CurrentSince Jan 15, 2022 Accepting new patients
Memorial Hospital at Gulfport CurrentSince May 26, 2025 Accepting new patients
Memorial Hospital at Gulfport Past Accepting new patients
Coastal Family Health Center, Inc PastSince Nov 10, 2014 Accepting new patients

Locations

967 Cedar Lake Rd
Biloxi, MS 39532
Phone (228) 205-6814

1340 Broad Ave
Ste 440
Gulfport, MS 39501
Phone (228) 867-4856

350 Cowan Rd
Gulfport, MS 39507
Phone (228) 206-7054

4211 Hospital St
Ste 202
Pascagoula, MS 39581
Phone (228) 372-8270

4300 Hospital St
Ste 102
Pascagoula, MS 39581
Phone (228) 372-8270

4603 Hospital St
Pascagoula, MS 39581
Phone (228) 762-1002

Organizations & group practices 9

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.

Hospital & facility affiliations 62

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 62

NPI Registry JSON

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

{
    "created_epoch": "1327276800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1586649600000",
    "number": "1275804270",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 850",
            "city": "HURLEY",
            "state": "MS",
            "postal_code": "395550850",
            "telephone_number": "228-588-2938",
            "fax_number": "228-588-9399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7001 HWY 614",
            "city": "HURLEY",
            "state": "MS",
            "postal_code": "39555",
            "telephone_number": "228-588-2938",
            "fax_number": "228-588-9399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ANTHONY",
        "middle_name": "T",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-01-23",
        "last_updated": "2020-04-12",
        "certification_date": "2020-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MN",
            "license": "R205397-4",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hurley, MS

Sources for this page

Verify at the official NPI Registry.