Individual provider Active NPI

Johnson Dean Tanner, M.D.

  • Diagnostic Radiology Physician
  • Ridgeland, MS
National Provider Identifier
1336237825
Registry record updated Oct 2, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
15195 Issued in MS
Practice address
113 W Jackson St Ste B
Ridgeland, MS 39157-2402
Phone
(601) 354-4327
Fax
(601) 360-0822
NPI assigned
Oct 10, 2006
Last updated
Oct 2, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 15195 MS
Diagnostic Radiology Physician 2085R0202X 15195 MS Primary

Addresses

Primary practice location

113 W Jackson St Ste B
Ridgeland, MS 39157-2402

Mailing address

350 N Humphreys Blvd
Memphis, TN 38120-2177
Phone (901) 226-4003

Other practice location 1

1225 N State St Ste 100
Jackson, MS 39202-2064
Phone (601) 714-6400

Other practice location 2

823 Grand Ave
Yazoo City, MS 39194-3233
Phone (662) 746-2261

Other practice location 3

100 Highway 16 E
Carthage, MS 39051-4202
Phone (601) 267-1100

Other practice location 4

2520 5th St N
Columbus, MS 39705-2008
Phone (662) 244-1670

Other practice location 5

220 Highway 12 W
Kosciusko, MS 39090-3208
Phone (662) 290-3315

Other practice location 6

100 Hospital St
Booneville, MS 38829-3354
Phone (662) 538-2110

Other practice location 7

140 Burke Calhoun City Rd
Calhoun City, MS 38916-9690
Phone (662) 628-6611

Other practice location 8

1225 N State St
Jackson, MS 39202-2064
Phone (601) 714-6400

Other identifiers 1

IdentifierTypeStateIssuer
0124325MedicaidMS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS, KY, WV, TN4 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 4

Enrollment IDStateProvider typePAC IDDetails
I20070716000527 MS Practitioner - Diagnostic Radiology 2668572025 Reassigns benefits to 6 organizations
I20250909003810 KY Practitioner - Diagnostic Radiology 2668572025 Reassigns benefits to 1 organization
I20251014003982 WV Practitioner - Diagnostic Radiology 2668572025 Reassigns benefits to 4 organizations
I20260305000531 TN Practitioner - Diagnostic Radiology 2668572025 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
University of Mississippi School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health AssociationGroup PAC ID 1759291313, 69 clinicians
Radiology Alliance PCGroup PAC ID 1850280470, 449 clinicians
Imaging Associates of Indiana PCGroup PAC ID 1254503345, 293 clinicians
THS Physician Partners IncGroup PAC ID 9537316393, 366 clinicians
Pikeville Medical Center IncGroup PAC ID 6709790157, 427 clinicians

Practice addresses (Care Compare)

122 Pinnell St
Ripley, WV 25271-9101
Phone (304) 372-2731

137 Woodland Hills Blvd
Madison, MS 39110-7823
Phone (615) 312-0600

190 Rolling Meadows Rd
Ridgeland, MS 39157-9442
Phone (219) 767-6320

2500 Hospital Dr
Martinsburg, WV 25401-3402
Phone (304) 264-1000

2500 N State St
Jackson, MS 39216-4500
Phone (601) 815-4775

253 Ridge Dr
Jackson, MS 39216-4112
Phone (888) 501-6087

4605 Maccorkle Ave SW
South Charleston, WV 25309-1311
Phone (304) 414-4800

911 Bypass Rd
BLDG a
Pikeville, KY 41501-1689
Phone (606) 430-3500

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
92.5 of 100Reported as group
Quality
85
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Adi Radiology PC Diagnostic Radiology CurrentSince Dec 31, 2025 Accepting new patients
Community Health Association CurrentSince Aug 23, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 5, 2025 Accepting new patients
Mississippi Hma Hospitalists, LLC Diagnostic Radiology CurrentSince Jan 25, 2025 Accepting new patients
West Virginia University Medical Corporation CurrentSince Jul 1, 2025 Accepting new patients
State of Mississippi - University of Mississippi Medical Center CurrentSince Jul 5, 2025 Accepting new patients
Mississippi Hma Hospitalists, LLC CurrentSince Jan 25, 2025 Accepting new patients
West Virginia University Medical Corporation Diagnostic Radiology CurrentSince Jul 1, 2025 Accepting new patients
Radiological Group, PA Specialist CurrentSince Oct 1, 2001 Accepting new patients
Pikeville Medical Center Inc. CurrentSince Aug 25, 2025 Accepting new patients
Community Health Association CurrentSince Aug 23, 2025 Accepting new patients
Imaging Associates of Indiana, PC Diagnostic Radiology CurrentSince Dec 9, 2025 Accepting new patients
Middle Tennessee Imaging LLC Diagnostic Radiology CurrentSince Dec 22, 2025 Accepting new patients
Radiology Alliance PC Diagnostic Radiology CurrentSince Dec 8, 2025 Accepting new patients
THS Physician Partners Inc CurrentSince Feb 6, 2026 Accepting new patients
Pikeville Medical Center Inc CurrentSince Aug 25, 2025 Accepting new patients
Community Health Association Past Accepting new patients

Locations

184 S Mayo Trl
Pikeville, KY 41501
Phone (606) 430-2213

911 Bypass Rd
Pikeville, KY 41501
Phone (606) 218-4530

911 Bypass Rd
Bldg A
Pikeville, KY 41501
Phone (606) 430-2201

350 Crossgates Blvd
Brandon, MS 39042
Phone (601) 824-8500

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

1225 N State St
Ste 2C
Jackson, MS 39202
Phone (601) 968-1000

1815 Hospital Dr
Jackson, MS 39204
Phone (601) 815-4775

2500 N State St
Jackson, MS 39216
Phone (601) 815-4775

1107 Highland Colony Pkwy
Ste 209
Ridgeland, MS 39157
Phone (601) 360-0823

113 W Jackson St
Ste B
Ridgeland, MS 39157

823 Grand Ave
Yazoo City, MS 39194
Phone (601) 746-2261

L3539
Columbus, OH 43260
Phone (304) 414-4800

2500 Hospital Dr
Martinsburg, WV 25401
Phone (304) 233-4134

1 Medical Center Dr
Morgantown, WV 26506
Phone (304) 293-4500

300 S Preston St
Ranson, WV 25438
Phone (304) 728-1600

122 Pinnell St
Ripley, WV 25271
Phone (304) 373-1544

4605 Maccorkle Ave SW
South Charleston, WV 25309
Phone (304) 414-4800

Interoperability endpoints

  • Direct secure messaging: jtanner219369@ummc.direct-ci.com

Organizations & group practices 17

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.

View all 17

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1160438400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790899200000",
    "number": "1336237825",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "350 N HUMPHREYS BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381202177",
            "telephone_number": "901-226-4003",
            "fax_number": "901-227-8591"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "113 W JACKSON ST STE B",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391572402",
            "telephone_number": "601-354-4327",
            "fax_number": "601-360-0822"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 N State St Ste 100",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022064",
            "country_code": "US",
            "telephone_number": "601-714-6400",
            "fax_number": "901-714-6499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "823 Grand Ave",
            "address_purpose": "LOCATION",
            "city": "Yazoo City",
            "state": "MS",
            "postal_code": "391943233",
            "country_code": "US",
            "telephone_number": "662-746-2261",
            "fax_number": "662-746-4839",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Highway 16 E",
            "address_purpose": "LOCATION",
            "city": "Carthage",
            "state": "MS",
            "postal_code": "390514202",
            "country_code": "US",
            "telephone_number": "601-267-1100",
            "fax_number": "601-267-1469",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2520 5th St N",
            "address_purpose": "LOCATION",
            "city": "Columbus",
            "state": "MS",
            "postal_code": "397052008",
            "country_code": "US",
            "telephone_number": "662-244-1670",
            "fax_number": "662-244-1058",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "220 Highway 12 W",
            "address_purpose": "LOCATION",
            "city": "Kosciusko",
            "state": "MS",
            "postal_code": "390903208",
            "country_code": "US",
            "telephone_number": "662-290-3315",
            "fax_number": "601-974-6245",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "100 Hospital St",
            "address_purpose": "LOCATION",
            "city": "Booneville",
            "state": "MS",
            "postal_code": "388293354",
            "country_code": "US",
            "telephone_number": "662-538-2110",
            "fax_number": "662-538-2110",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "140 Burke Calhoun City Rd",
            "address_purpose": "LOCATION",
            "city": "Calhoun City",
            "state": "MS",
            "postal_code": "389169690",
            "country_code": "US",
            "telephone_number": "662-628-6611",
            "fax_number": "662-628-6300",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1225 N State St",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392022064",
            "country_code": "US",
            "telephone_number": "601-714-6400",
            "fax_number": "601-714-6499",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JOHNSON",
        "middle_name": "DEAN",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-10",
        "last_updated": "2026-10-02",
        "certification_date": "2026-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "MS",
            "license": "15195",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "MS",
            "license": "15195",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0124325",
            "state": "MS"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Ridgeland, MS

Sources for this page

Verify at the official NPI Registry.