Active NPI
Tanner Sean Harvey, SOIDC
- Independent Duty Corpsman
- Virginia Beach, VA
National Provider Identifier
1538795679
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Independent Duty Corpsman
- Practice address
- 472 Polaris Avenue
Virginia Beach, VA 23461 - Phone
- (757) 862-2715
- NPI assigned
- Mar 20, 2020
- Last updated
- Jun 26, 2023
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Independent Duty Corpsman | 1710I1002X | Primary |
Addresses
Primary practice location
472 Polaris Avenue
Virginia Beach, VA 23461
Mailing address
1MRB Bas
Apo, AA 92010
Phone (760) 500-0719
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710I1002X | Other | NC | MILITARY HEALTH CARE PROVIDER - INDEPENDENT DUTY CORPSMAN |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584662400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1687737600000",
"number": "1538795679",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "MIL",
"address_1": "1MRB BAS",
"city": "APO",
"state": "AA",
"postal_code": "92010",
"telephone_number": "760-500-0719"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "472 POLARIS AVENUE",
"city": "VIRGINIA BEACH",
"state": "VA",
"postal_code": "23461",
"telephone_number": "757-862-2715"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HARVEY",
"first_name": "TANNER",
"middle_name": "SEAN",
"credential": "SOIDC",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2020-03-20",
"last_updated": "2023-06-26",
"certification_date": "2023-06-26",
"status": "A"
},
"taxonomies": [
{
"code": "1710I1002X",
"taxonomy_group": "",
"desc": "Military Health Care Provider, Independent Duty Corpsman",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MILITARY HEALTH CARE PROVIDER - INDEPENDENT DUTY CORPSMAN",
"identifier": "1710I1002X",
"state": "NC"
}
],
"endpoints": [],
"other_names": []
}Other providers in Virginia Beach, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 26, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.