Judy Ann Taber-Tanis, FNP, BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704197858 Issued in MI

Practice address

204 W Main St
Fremont, MI 49412-1181

Phone

(231) 924-1800

NPI assigned

Oct 2, 2012

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

Practice roles

Locations

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.

• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1235188673
  Medicare reassignment NPD
• Spectrum Health Primary Care Partners

  • Radiology Clinic/Center
  • Grand Rapids, MI
  • NPI 1528374683
  NPD
• Spectrum Health Primary Care Partners

  • Internal Medicine Physician
  • Grand Rapids, MI
  • NPI 1689499667
  NPD
• Newaygo County General Hospital Association

  • Hospitalist Physician
  • Fremont, MI
  • NPI 1750404927
  NPD (past)

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

{
    "created_epoch": "1349136000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709251200000",
    "number": "1487905360",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MICHIGAN ST NE",
            "address_2": "MC 845",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495032560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "204 W MAIN ST",
            "city": "FREMONT",
            "state": "MI",
            "postal_code": "494121181",
            "telephone_number": "231-924-1800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TABER-TANIS",
        "first_name": "JUDY",
        "middle_name": "ANN",
        "credential": "FNP, BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-02",
        "last_updated": "2024-03-01",
        "certification_date": "2024-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704197858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Melissa Stevens
• Cathy L Stout, PA
• Adam Evan Strantz, PA-C
• Shana Marie Strantz, PA
• Cymber Bre Stroven, NP-C
• Sandy Terwillegar, MA, LLP
• The Country Squire Discount Pharmacy, Inc
• Mary J Thompson-Rottier, LPC
• Laura Lee Thompson
• Emily Kathryn Thrower, C.N.M.

• Family Nurse Practitioner in Fremont, MI
• Providers in Fremont, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 1, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.