David Eric Tanner, DO

Primary specialty

Neuromusculoskeletal Medicine & OMM PhysicianTaxonomy code 204D00000X

License

38635 Issued in CO

Practice address

5387 Manhattan Cir
Suite 201
Boulder, CO 80303-4284

Phone

(303) 494-2705

Fax

(303) 494-2706

NPI assigned

Jul 23, 2006

Last updated

Dec 6, 2007By the provider in NPPES

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 CO

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physical Medicine and RehabilitationAlso: Osteopathic Manipulative Medicine

Education

University of New England, College of Osteo Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Creekside Physical Medicine PLLCGroup PAC ID 1658373923, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy, Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: david.tanner.1@34007.direct.athenahealth.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Creekside Physical Medicine PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Boulder, CO
  • NPI 1578601969
  Medicare reassignment Care Compare group NPD Authorized official
• Creekside Physical Medicine PLLC

  • Neuromusculoskeletal Medicine & OMM Physician
  • Longmont, CO
  • NPI 1972101202
  NPD

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

{
    "created_epoch": "1153612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1196899200000",
    "number": "1609897578",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5387 MANHATTAN CIR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034284",
            "telephone_number": "303-494-2705",
            "fax_number": "303-494-2706"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5387 MANHATTAN CIR",
            "address_2": "SUITE 201",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "803034284",
            "telephone_number": "303-494-2705",
            "fax_number": "303-494-2706"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "DAVID",
        "middle_name": "ERIC",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-23",
        "last_updated": "2007-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": "CO",
            "license": "38635",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Talagrand
• Talk Therapy Corporation
• Pamela Phelps Talley, MD
• Elizabeth Tamaren
• Melissa Tangney
• Diana Carol Tanney
• Tamora Tanniehill, MA
• Seneca Webb Tantum, PT
• Tanya Tivorsak MD PC
• Yangchan Tanzin

• Neuromusculoskeletal Medicine & OMM Physician in Boulder, CO
• Providers in Boulder, CO by specialty
• Neuromusculoskeletal Medicine & OMM Physician in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2007; 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.
• 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.