Individual provider Active NPI

Tanya S Tanner, PHD APN CNM PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Broomfield, CO
National Provider Identifier
1437147444
Registry record updated May 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
APN.0996437-NP Issued in CO
Practice address
80 Garden Ctr Ste 138
Broomfield, CO 80020-1790
Phone
(720) 415-0101
Fax
(833) 907-2210
NPI assigned
Oct 12, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Advanced Practice Midwife 367A00000X 2154 CO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APN.0996437-NP CO Primary

Addresses

Primary practice location

80 Garden Ctr Ste 138
Broomfield, CO 80020-1790

Mailing address

11164 Cherokee St
Northglenn, CO 80234-3918
Phone (303) 918-9828

Other practice location 1

11164 Cherokee St
Northglenn, CO 80234-3918
Phone (720) 415-0101

Other practice location 2

12687 Locust Way
Thornton, CO 80602-4664
Phone (720) 415-0101

Other identifiers 1

IdentifierTypeStateIssuer
90409523MedicaidCO

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CO
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050404000780 CO Practitioner - Certified Nurse Midwife (CNM) 2466409230 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Certified Nurse Midwife (CNM)
Education
University of Utah School of Medicine, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Northglenn, CO 80234
Phone (720) 415-0101

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Nurse Midwife, Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
2154COMDClinical Psychologist
APN.0996437-NPCOMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Cultivate Mental Health PC Psychiatric/Mental Health CurrentSince May 6, 2021 Accepting new patients

Locations

80 Garden Ctr
Ste 138
Broomfield, CO 80020
Phone (720) 415-0101

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/24067/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tanya.tanner.1@24067.direct.athenahealth.com

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1129075200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1683936000000",
    "number": "1437147444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11164 CHEROKEE ST",
            "city": "NORTHGLENN",
            "state": "CO",
            "postal_code": "802343918",
            "telephone_number": "303-918-9828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 GARDEN CTR STE 138",
            "city": "BROOMFIELD",
            "state": "CO",
            "postal_code": "800201790",
            "telephone_number": "720-415-0101",
            "fax_number": "833-907-2210"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11164 Cherokee St",
            "address_purpose": "LOCATION",
            "city": "Northglenn",
            "state": "CO",
            "postal_code": "802343918",
            "country_code": "US",
            "telephone_number": "720-415-0101",
            "fax_number": "303-529-3167",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "12687 Locust Way",
            "address_purpose": "LOCATION",
            "city": "Thornton",
            "state": "CO",
            "postal_code": "806024664",
            "country_code": "US",
            "telephone_number": "720-415-0101",
            "fax_number": "833-907-2210",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "TANYA",
        "middle_name": "S",
        "name_prefix": "Dr.",
        "credential": "PHD APN CNM PMHNP-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-10-12",
        "last_updated": "2023-05-13",
        "certification_date": "2023-05-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367A00000X",
            "taxonomy_group": "",
            "desc": "Advanced Practice Midwife",
            "state": "CO",
            "license": "2154",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "CO",
            "license": "APN.0996437-NP",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "90409523",
            "state": "CO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Broomfield, CO

Sources for this page

Verify at the official NPI Registry.