Individual provider Active NPI

Erika Love Tanner, M.D.

  • Obstetrics & Gynecology Physician
  • Madison, MS
National Provider Identifier
1679732788
Registry record updated Jun 23, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
License
21057 Issued in MS
Practice address
115 Fountains Blvd
Suite a
Madison, MS 39110-6344
Phone
(601) 853-0100
Fax
(601) 853-3999
NPI assigned
Jun 3, 2008
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Obstetrics & Gynecology Physician 207V00000X 21057 MS Primary

Addresses

Primary practice location

115 Fountains Blvd
Suite a
Madison, MS 39110-6344

Mailing address

115 Fountains Blvd
Suite a
Madison, MS 39110-6344
Phone (601) 853-0100

Medicare participation

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

Enrollment IDStateProvider typePAC IDDetails
I20101029001014 MS Practitioner - Obstetrics/Gynecology 1850585274 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
University of Mississippi School of Medicine, 2006
Medicare assignment
May accept Medicare assignment
Group practices
Madison OB/GYN Associates, LLCGroup PAC ID 3274785746, 2 clinicians

Practice addresses (Care Compare)

115 Fountains Blvd
Suite a
Madison, MS 39110-6344
Phone (601) 853-0100

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
21057MSMDObstetrics & Gynecology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Madison OB/GYN Associates LLC Obstetrics & Gynecology CurrentSince Mar 29, 2015 Accepting new patients
Obhg Mississippi, P.C. Obstetrics & Gynecology CurrentSince Apr 24, 2020 Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients
Vicksburg Clinic LLC Past Accepting new patients

Locations

160 River Oaks Dr
#B
Canton, MS 39046
Phone (601) 761-7280

1225 N State St
Jackson, MS 39202
Phone (601) 292-4261

969 Lakeland Dr
Jackson, MS 39216
Phone (601) 200-4644

115 Fountains Blvd
#A
Madison, MS 39110
Phone (601) 853-0100

7601 Southcrest Pkwy
Southaven, MS 38671
Phone (662) 349-4000

Organizations & group practices 4

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

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1212451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1466640000000",
    "number": "1679732788",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "115 FOUNTAINS BLVD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106344",
            "telephone_number": "601-853-0100",
            "fax_number": "601-853-3999"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "115 FOUNTAINS BLVD",
            "address_2": "SUITE A",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391106344",
            "telephone_number": "601-853-0100",
            "fax_number": "601-853-3999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ERIKA",
        "middle_name": "LOVE",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-03",
        "last_updated": "2016-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "MS",
            "license": "21057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Madison, MS

Sources for this page

Verify at the official NPI Registry.