Individual provider Active NPI

Kristina Schultz Tanner, APRN, MSN, FNP-C

  • Family Nurse Practitioner
  • Athens, GA
National Provider Identifier
1558712307
Registry record updated Jul 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
RN157317 Issued in GA
Practice address
3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone
(706) 353-2990
Fax
(706) 353-2992
NPI assigned
Jun 23, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X RN157317 GA Primary

Addresses

Primary practice location

3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400

Mailing address

3320 Old Jefferson Rd BLDG 800
Athens, GA 30607-1400
Phone (706) 353-2990

Other practice location 1

3320 Old Jefferson Rd Bldg 700
Athens, GA 30607-1465
Phone (706) 353-2990

Other practice location 2

1460 Resurgence Dr
Watkinsville, GA 30677-7320
Phone (706) 715-2410

Other practice location 3

4182 Highway 278 NE
Covington, GA 30014-2494
Phone (678) 712-6921

Other practice location 4

1199 Prince Ave
Loran Smith Center for Cancer Support
Athens, GA 30606-2797
Phone (706) 475-5324

Other identifiers 1

IdentifierTypeStateIssuer
003234315AMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in GA
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

Enrollment IDStateProvider typePAC IDDetails
I20160822002365 GA Practitioner - Nurse Practitioner 7214222843 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

3320 Old Jefferson Rd
BLDG 700
Athens, GA 30607-1465
Phone (706) 353-2990

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
99
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science - Nursing

State licenses

LicenseStateTypeSpecialty
RN157317GAMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Cancer & Blood Center LLC CurrentSince Jun 15, 2020 Accepting new patients

Locations

1199 Prince Ave
Athens, GA 30606
Phone (706) 354-3520

3320 Old Jefferson Rd
Bldg 800
Athens, GA 30607
Phone (706) 353-2290

3320 Old Jefferson Rd
Bldg 700
Athens, GA 30607
Phone (706) 224-6348

3320 Old Jefferson Rd
Ste 600
Athens, GA 30607
Phone (706) 549-4155

110 Mercer Pl
Commerce, GA 30529
Phone (706) 335-2302

4182 Highway 278 NE
Covington, GA 30014
Phone (678) 712-6921

119 Harmony Xing
Ste 1
Eatonton, GA 31024
Phone (762) 220-1880

355 Clear Creek Pkwy
Ste 2007
Lavonia, GA 30553
Phone (706) 356-2934

2151 W Spring St
Ste B200
Monroe, GA 30655
Phone (770) 267-0724

1656 Falls Rd
Ste B
Toccoa, GA 30577
Phone (706) 886-0392

1460 Resurgence Dr
Watkinsville, GA 30677
Phone (706) 715-2410

295 N Broad St
Winder, GA 30680
Phone (678) 963-0939

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": "1466640000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721347200000",
    "number": "1558712307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 OLD JEFFERSON RD BLDG 800",
            "city": "ATHENS",
            "state": "GA",
            "postal_code": "306071400",
            "telephone_number": "706-353-2990",
            "fax_number": "706-353-2992"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3320 Old Jefferson Rd Bldg 700",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306071465",
            "country_code": "US",
            "telephone_number": "706-353-2990",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1460 Resurgence Dr",
            "address_purpose": "LOCATION",
            "city": "Watkinsville",
            "state": "GA",
            "postal_code": "306777320",
            "country_code": "US",
            "telephone_number": "706-715-2410",
            "fax_number": "706-353-2992",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4182 Highway 278 NE",
            "address_purpose": "LOCATION",
            "city": "Covington",
            "state": "GA",
            "postal_code": "300142494",
            "country_code": "US",
            "telephone_number": "678-712-6921",
            "fax_number": "678-712-6923",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1199 Prince Ave",
            "address_2": "Loran Smith Center for Cancer Support",
            "address_purpose": "LOCATION",
            "city": "Athens",
            "state": "GA",
            "postal_code": "306062797",
            "country_code": "US",
            "telephone_number": "706-475-5324",
            "fax_number": "706-475-2121",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SCHULTZ TANNER",
        "first_name": "KRISTINA",
        "credential": "APRN, MSN, FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-23",
        "last_updated": "2024-07-19",
        "certification_date": "2024-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN157317",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "003234315A",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Athens, GA

Sources for this page

Verify at the official NPI Registry.