Active NPI
David E Tanner, D.O.
- General Practice Physician
- Newport, PA
National Provider Identifier
1629032776
On this page
Key facts
NPPES NPI Registry- Primary specialty
- General Practice Physician
- License
- OSOO4411L
- Practice address
- 82 Red Hill Rd
Newport, PA 17074-8708 - Phone
- (717) 567-7884
- NPI assigned
- Apr 14, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| General Practice Physician | 208D00000X | OSOO4411L | PA | Primary |
Addresses
Primary practice location
82 Red Hill Rd
Newport, PA 17074-8708
Mailing address
82 Red Hill Rd
P.O. Box 10
Newport, PA 17074-8708
Phone (717) 567-7884
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0005986020003 | Medicaid | PA | |
| 080031059 | Other | PW | PALMETTA GBA |
| TA148070 | Other | PA | HIGHMARK BLUE SHIELD |
| 01014602 | Other | PA | CAPITAL BLUE CROSS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in PA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110104001263 | PA | Practitioner - General Practice | 0345439519 | Practice locations: Newport, PA |
Care Compare profile
Medicare Care Compare- Specialty
- General Practice
- Education
- Philadelphia College of Osteopathic Medicine, 1979
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
Practice addresses (Care Compare)
82 Red Hill Rd
Newport, PA 17074-8708
Phone (717) 567-7884
PO Box
Suite 10
Newport, PA 17074
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Osteopathy
Hospital & facility affiliations 7
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- Harrisburg, PA
- NPI 1265537674
-
- General Acute Care Hospital
- Harrisburg, PA
- NPI 1407813603
-
dba UPMC Pinnacle West Shore
- General Acute Care Hospital
- Mechanicsburg, PA
- NPI 1972613305
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1144972800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277683200000",
"number": "1629032776",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 RED HILL RD",
"address_2": "P.O. BOX 10",
"city": "NEWPORT",
"state": "PA",
"postal_code": "170748708",
"telephone_number": "717-567-7884"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "82 RED HILL RD",
"city": "NEWPORT",
"state": "PA",
"postal_code": "170748708",
"telephone_number": "717-567-7884"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "DAVID",
"middle_name": "E",
"credential": "D.O.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-04-14",
"last_updated": "2010-06-28",
"status": "A"
},
"taxonomies": [
{
"code": "208D00000X",
"taxonomy_group": "",
"desc": "General Practice",
"state": "PA",
"license": "OSOO4411L",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "0005986020003",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PALMETTA GBA",
"identifier": "080031059",
"state": "PW"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HIGHMARK BLUE SHIELD",
"identifier": "TA148070",
"state": "PA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CAPITAL BLUE CROSS",
"identifier": "01014602",
"state": "PA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Newport, PA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2010; 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.