Tanner Williams, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

27077 Issued in MT

Practice address

2788 Sheffield Dr
Missoula, MT 59808-5881

Phone

(307) 399-5416

NPI assigned

Jun 27, 2023

Sex

Male

Sole proprietor

Yes

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 MT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2023

Medicare assignment

May accept Medicare assignment

Group practices

Active Physical Therapy and Sports Injury Center LLCGroup PAC ID 5799709523, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Active Physical Therapy & Sports Injury Center, LLC

  • Physical Therapist
  • Missoula, MT
  • NPI 1316949340
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1687824000000",
    "number": "1578249140",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2788 SHEFFIELD DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085881"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2788 SHEFFIELD DR",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598085881",
            "telephone_number": "307-399-5416"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIAMS",
        "first_name": "TANNER",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2023-06-27",
        "last_updated": "2023-06-27",
        "certification_date": "2023-06-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "MT",
            "license": "27077",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Heather Neilson Williams, M.S., ED.S., PCLC
• Kelly Whetstone Williams, ARNP
• Megan Williams, RBT
• Sydney Williams
• Tami Marie Williams, LCPC
• Celeste Willis
• Jeff R Willis, M.D.
• Jordan Willis, RPH
• Lauren K Willis, M.D.
• John A. Willoughby, MD

• Physical Therapist in Missoula, MT
• Providers in Missoula, MT by specialty
• Physical Therapist in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.