Active NPI
Tanner Boyle, PA-C
- Physician Assistant
- Richmond Hill, GA
National Provider Identifier
1629869508
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physician Assistant
- License
- 12985
- Practice address
- 2701 US Highway 17 Ste 1B
Richmond Hill, GA 31324-3863 - Phone
- (912) 727-7546
- Fax
- (912) 445-2960
- NPI assigned
- May 13, 2025
- Last updated
- May 13, 2025
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 12985 | GA | Primary |
Addresses
Primary practice location
2701 US Highway 17 Ste 1B
Richmond Hill, GA 31324-3863
Mailing address
2400 Bellevue Rd Ste 21a
Dublin, GA 31021-2890
Phone (478) 328-0281
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in GA
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physician Assistant
- Education
- Lincoln Memorial University Medical Department, 2024
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
2400 Bellevue Rd
Suite 21a
Dublin, GA 31021-2845
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Georgia Dermatology &Skin Cancer Center, PC | Past | Accepting new patients |
Organizations & group practices 2
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.
-
- Dermatology Physician
- Dublin, GA
- NPI 1063460459
-
- Dermatology Physician
- Macon, GA
- NPI 1447363346
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1747094400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1747094400000",
"number": "1629869508",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2400 BELLEVUE RD STE 21A",
"city": "DUBLIN",
"state": "GA",
"postal_code": "310212890",
"telephone_number": "478-328-0281",
"fax_number": "478-328-1433"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2701 US HIGHWAY 17 STE 1B",
"city": "RICHMOND HILL",
"state": "GA",
"postal_code": "313243863",
"telephone_number": "912-727-7546",
"fax_number": "912-445-2960"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BOYLE",
"first_name": "TANNER",
"credential": "PA-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2025-05-13",
"last_updated": "2025-05-13",
"certification_date": "2025-05-13",
"status": "A"
},
"taxonomies": [
{
"code": "363A00000X",
"taxonomy_group": "",
"desc": "Physician Assistant",
"state": "GA",
"license": "12985",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Richmond Hill, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2025; 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.