Patrick C. Tanner, AT-C

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT001018 Issued in GA

Practice address

1285 Hembree Rd
Suite 200-D
Roswell, GA 30076-5720

Phone

(770) 772-5540

Fax

(770) 772-5541

NPI assigned

Apr 12, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1144800000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1207612800000",
    "number": "1720042450",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1285 HEMBREE RD",
            "address_2": "SUITE 200-D",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765720",
            "telephone_number": "770-772-5540",
            "fax_number": "770-772-5541"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1285 HEMBREE RD",
            "address_2": "SUITE 200-D",
            "city": "ROSWELL",
            "state": "GA",
            "postal_code": "300765720",
            "telephone_number": "770-772-5540",
            "fax_number": "770-772-5541"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "PATRICK",
        "middle_name": "C.",
        "credential": "AT-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-12",
        "last_updated": "2008-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT001018",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Athletic Trainer in Roswell, GA
• Providers in Roswell, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.