NPIMap

Organization Active NPI

Tanner Memorial Clinic

  • Gastroenterology Physician
  • Ogden, UT
National Provider Identifier
1609406511
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gastroenterology PhysicianTaxonomy code 207RG0100X
Legal business name
TANNER MEMORIAL CLINIC
Practice address
6028 S Ridgeline Dr Ste 201
Ogden, UT 84405-6908
Phone
(801) 773-4840
Fax
(801) 525-8151
NPI assigned
Jan 20, 2020
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Kevin Spainhower
Title
Business Services Director
Phone
(801) 525-8726

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Gastroenterology Physician 207RG0100X NU Primary

Addresses

Primary practice location

6028 S Ridgeline Dr Ste 201
Ogden, UT 84405-6908

Mailing address

PO Box 337
Layton, UT 84041-0337
Phone (801) 773-4840

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000132 UT Part B Supplier - Clinic/Group Practice 4284547985 Receives reassigned benefits from 314 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Syracuse, UT; Roy, UT; Ogden, UT; Murray, UT; Layton, UT; Kaysville, UT; Farmington, UT; Clinton, UT

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
De J Cutler MD10 organizations share this tax ID, including this one

Other organizations with this tax ID 9

Organizations that report the same tax identification number in the National Provider Directory.

Locations

1477 N 2000 W
Ste C
Clinton, UT 84015
Phone (801) 546-9441

Practitioners & affiliated clinicians

Practitioners 44

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 44

NPI Registry JSON

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

{
    "created_epoch": "1579478400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1609406511",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 337",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840410337",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6028 S RIDGELINE DR STE 201",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844056908",
            "telephone_number": "801-773-4840",
            "fax_number": "801-525-8151"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNER MEMORIAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-20",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "SPAINHOWER",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "BUSINESS SERVICES DIRECTOR",
        "authorized_official_telephone_number": "801-525-8726"
    },
    "taxonomies": [
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.