NPIMap

Individual provider Active NPI

Andy R Tanner, D.O.

  • Family Medicine Physician
  • Charleston, WV
National Provider Identifier
1689776387
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
1817 Issued in WV
Practice address
511 Morris St
Charleston, WV 25301-1326
Phone
(304) 525-7851
NPI assigned
Sep 2, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 1817 WV Primary

Addresses

Primary practice location

511 Morris St
Charleston, WV 25301-1326

Mailing address

99 Cracker Barrel Dr Ste 100
Barboursville, WV 25504-1650
Phone (304) 525-7851

Other practice location 1

376 Kenmore Dr
Danville, WV 25053-7083
Phone (304) 525-7851

Other practice location 2

55 Donohoe Dr
Huntington, WV 25705-8887
Phone (304) 525-7851

Other identifiers 1

IdentifierTypeStateIssuer
1805842000MedicaidWV

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WV
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050929000004 WV Practitioner - Family Practice 2466487327 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
West Virginia School of Osteopathic Medicine, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

376 Kenmore Dr
Danville, WV 25053-7083
Phone (304) 525-7851

501 Morris St
Charleston, WV 25301-1326
Phone (304) 388-5432

Hospital & facility affiliations

  • Charleston Area Medical Center Hospital, Charleston, WV, CCN 510022
  • Thomas Memorial Hospital Hospital, South Charleston, WV, CCN 510029

Merit-based Incentive Payment System (MIPS)

Final score
90.94 of 100Reported as apm
Quality
69.71
Promoting interoperability
100
Improvement activities
40

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
1817WVMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Charleston Area Medical Center Inc CurrentSince Aug 1, 2006 Accepting new patients
Prestera Center for Mental Health Services Inc Family Medicine CurrentSince Oct 18, 2009 Accepting new patients
Prestera Center for Mental Health Services Inc CurrentSince Oct 18, 2009 Accepting new patients
Partnership of African American Churches Inc. CurrentSince Oct 12, 2020 Accepting new patients
Charleston Area Medical Center, Inc. Current Accepting new patients
National Emergency Services West Virginia Inc Past Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients
Patrtnership of African American Churches PastSince Oct 12, 2020 Accepting new patients
Charleston Area Medical Center Inc Past Accepting new patients

Locations

99 Cracker Barrel Dr
Ste 100
Barboursville, WV 25504
Phone 30452578512514

25 Lincoln Plz
Branchland, WV 25506
Phone (304) 525-7854

1514 Kanawha Blvd W
Charleston, WV 25387
Phone (304) 610-9964

501 Morris St
Charleston, WV 25301
Phone (304) 348-6293

511 Morris St
Ste 306
Charleston, WV 25301

3200 Maccorkle Ave SE
Fl 5
Charleston, WV 25304
Phone (304) 388-1000

3200 Maccorkle Ave SE
#C
Charleston, WV 25304
Phone (304) 347-1336

3200 Maccorkle Ave SE
Charleston, WV 25304
Phone (304) 388-2550

800 Pennsylvania Ave
Charleston, WV 25302
Phone (304) 388-2550

511 Morris St
Charleston, WV 25301
Phone (304) 341-0511

376 Kenmore Dr
Danville, WV 25053
Phone (304) 369-1930

625 8th St
Huntington, WV 25701
Phone (681) 208-4535

55 Donohoe Dr
Huntington, WV 25705

710 Viand St
Point Pleasant, WV 25550
Phone 3045257851 ext. 3520

712 Main St
Pt Pleasant, WV 25550

Organizations & group practices 9

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 12

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": "1157155200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1689776387",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "99 CRACKER BARREL DR STE 100",
            "city": "BARBOURSVILLE",
            "state": "WV",
            "postal_code": "255041650",
            "telephone_number": "304-525-7851"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "511 MORRIS ST",
            "city": "CHARLESTON",
            "state": "WV",
            "postal_code": "253011326",
            "telephone_number": "304-525-7851"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "376 Kenmore Dr",
            "address_purpose": "LOCATION",
            "city": "Danville",
            "state": "WV",
            "postal_code": "250537083",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "55 Donohoe Dr",
            "address_purpose": "LOCATION",
            "city": "Huntington",
            "state": "WV",
            "postal_code": "257058887",
            "country_code": "US",
            "telephone_number": "304-525-7851",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TANNER",
        "first_name": "ANDY",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-09-02",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "1817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1805842000",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, WV

Sources for this page

Verify at the official NPI Registry.