Active NPI
Chad Douglas Tanner, BSWAM LMT,CMT
- Massage Therapist
- Hardwick, VT
National Provider Identifier
1407989940
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Massage Therapist
- License
- MAT-9525
- Practice address
- 4 S Main St
Hardwick Inn 3Rd Floor Suite 10
Hardwick, VT 05843 - Phone
- (802) 279-3839
- NPI assigned
- Mar 13, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Massage Therapist | 225700000X | MAT-9525 | HI | Primary |
Addresses
Primary practice location
4 S Main St
Hardwick Inn 3Rd Floor Suite 10
Hardwick, VT 05843
Mailing address
PO Box 91
Hardwick, VT 05843-0091
Phone (802) 279-3839
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MAT-9525 | HI | MD | Massage Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173744000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1320192000000",
"number": "1407989940",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 91",
"city": "HARDWICK",
"state": "VT",
"postal_code": "058430091",
"telephone_number": "802-279-3839"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4 S MAIN ST",
"address_2": "HARDWICK INN 3RD FLOOR SUITE 10",
"city": "HARDWICK",
"state": "VT",
"postal_code": "05843",
"telephone_number": "802-279-3839"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "CHAD",
"middle_name": "DOUGLAS",
"credential": "BSWAM LMT,CMT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-13",
"last_updated": "2011-11-02",
"status": "A"
},
"taxonomies": [
{
"code": "225700000X",
"taxonomy_group": "",
"desc": "Massage Therapist",
"state": "HI",
"license": "MAT-9525",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Hardwick, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 2, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.