Active NPI
David Ross Tanner, D.C.
- Chiropractor
- Lincoln Park, NJ
National Provider Identifier
1629190723
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- MCC 00228900
- Practice address
- 212 Main St
Lincoln Park, NJ 07035-3700 - Phone
- (973) 268-7723
- Fax
- (973) 628-7742
- NPI assigned
- Apr 6, 2007
- 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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | MCC 00228900 | NJ | Primary |
Addresses
Primary practice location
212 Main St
Lincoln Park, NJ 07035-3700
Mailing address
17 Sunrise Way
Towaco, NJ 07082-1547
Phone (973) 334-2664
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 22 24230010 | Other | NJ | HORIZON BC BS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MCC 00228900 | NJ | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1175817600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1629190723",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "17 SUNRISE WAY",
"city": "TOWACO",
"state": "NJ",
"postal_code": "070821547",
"telephone_number": "973-334-2664",
"fax_number": "973-682-7742"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "212 MAIN ST",
"city": "LINCOLN PARK",
"state": "NJ",
"postal_code": "070353700",
"telephone_number": "973-268-7723",
"fax_number": "973-628-7742"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "DAVID",
"middle_name": "ROSS",
"name_prefix": "Dr.",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-06",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "NJ",
"license": "MCC 00228900",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "HORIZON BC BS",
"identifier": "22 24230010",
"state": "NJ"
}
],
"endpoints": [],
"other_names": []
}Other providers in Lincoln Park, NJ
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.