Individual provider Active NPI

Tanner Davis, D.O.

  • Emergency Medicine Physician
  • Muskegon, MI
National Provider Identifier
1447601570
Registry record updated Jun 30, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
5101022722 Issued in MI
Practice address
1675 Leahy St Ste 315a
Muskegon, MI 49442-5543
Phone
(231) 727-5223
NPI assigned
Jun 30, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 5101022722 MI Primary

Addresses

Primary practice location

1675 Leahy St Ste 315a
Muskegon, MI 49442-5543

Mailing address

1675 Leahy St Ste 315a
Muskegon, MI 49442-5543
Phone (231) 727-5223

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
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 1

Enrollment IDStateProvider typePAC IDDetails
I20200411000760 IA Practitioner - Emergency Medicine 2860737905 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Linn County Emergency Medicine PCGroup PAC ID 9830089275, 35 clinicians
Johnson County Emergency Medicine PLCGroup PAC ID 6901231810, 29 clinicians

Practice addresses (Care Compare)

1195 Boyson Rd
Suite 101
Hiawatha, IA 52233-2218
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245-2633
Phone (319) 339-0300

Hospital & facility affiliations

  • Mercy Medical Center - Cedar Rapids Hospital, Cedar Rapids, IA, CCN 160079
  • University of Iowa Health Care Medical Center Down Hospital, Iowa City, IA, CCN 160029

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Johnson County Emergency Medicine, PLC Emergency Medicine CurrentSince Mar 5, 2020 Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Mar 5, 2020 Accepting new patients
Linn County Emergency Medicine PC Emergency Medicine CurrentSince Mar 5, 2020 Accepting new patients

Locations

701 10th St SE
Cedar Rapids, IA 52403
Phone (319) 398-6011

1195 Boyson Rd
Ste 101
Hiawatha, IA 52233
Phone (319) 832-3950

500 E Market St
Iowa City, IA 52245
Phone (319) 339-0300

999 35th St
Marion, IA 52302

Organizations & group practices 3

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.

Hospital & facility affiliations 2

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": "1467244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1467244800000",
    "number": "1447601570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-727-5223"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1675 LEAHY ST STE 315A",
            "city": "MUSKEGON",
            "state": "MI",
            "postal_code": "494425543",
            "telephone_number": "231-727-5223"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAVIS",
        "first_name": "TANNER",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-06-30",
        "last_updated": "2016-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "MI",
            "license": "5101022722",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Muskegon, MI

Sources for this page

Verify at the official NPI Registry.