NPIMap

Individual provider Active NPI

John P Tanner, MD

  • Family Medicine Physician
  • Raleigh, NC
National Provider Identifier
1699983411
Registry record updated Mar 3, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2007-00964 Issued in NC
Practice address
601 Oberlin Rd
Raleigh, NC 27605-1126
Phone
(919) 235-6566
NPI assigned
May 18, 2007
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 3, 2021

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 2007-00964 NC Primary

Addresses

Primary practice location

601 Oberlin Rd
Raleigh, NC 27605-1126

Mailing address

601 Oberlin Rd
Raleigh, NC 27605-1126
Phone (919) 235-6566

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20070926001006 NC Practitioner - Family Practice 6406941152 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Brody School of Medicine at East Carolina University, 2004
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Legacy Healthcare Services IncGroup PAC ID 2163339722, shared by 46 NPIs, 3,431 clinicians
Wake Specialty Physicians LLCGroup PAC ID 7416006085, 178 clinicians

Practice addresses (Care Compare)

2701 Pickett Rd
Durham, NC 27705-5688
Phone (919) 419-9600

7124 Knightdale Blvd
Knightdale, NC 27545-9265
Phone (919) 266-6211

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2007-00964NCMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Specialty Physicians, LLC Family Medicine Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Dec 15, 2020 Accepting new patients
Wake Specialty Physicians Family Medicine CurrentSince Mar 11, 2019 Accepting new patients
Wakemed Specialists Group, LLC Current Accepting new patients
Wakemed Specialists Group LLC CurrentSince Dec 15, 2020 Accepting new patients
Wake Specialty Physicians LLC CurrentSince Mar 11, 2019 Accepting new patients

Locations

811 US 70 Hwy W
Garner, NC 27529
Phone (919) 235-6565

7124 US Highway 64 E
Knightdale, NC 27545
Phone (919) 266-6211

3000 New Bern Ave
Raleigh, NC 27610
Phone (919) 350-7000

10000 Falls of Neuse Rd
Raleigh, NC 27614
Phone (919) 350-1300

601 Oberlin Rd
Raleigh, NC 27605
Phone (919) 235-6566

10000 Falls of Neuse Rd
Ste 205
Raleigh, NC 27614
Phone (919) 350-1630

Organizations & group practices 6

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 9

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": "1179446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614729600000",
    "number": "1699983411",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "601 OBERLIN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051126",
            "telephone_number": "919-235-6566"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 OBERLIN RD",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276051126",
            "telephone_number": "919-235-6566"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JOHN",
        "middle_name": "P",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-05-18",
        "last_updated": "2021-03-03",
        "certification_date": "2021-03-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "2007-00964",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

Verify at the official NPI Registry.