Active NPI
Duane Lee Tanner, O.D.
- Optometrist
- Midvale, UT
National Provider Identifier
1730197245
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Optometrist
- License
- 1130919934
- Practice address
- 914 Fort Union Blvd
Midvale, UT 84047-1714 - Phone
- (801) 561-4282
- Fax
- (801) 561-4283
- NPI assigned
- Aug 3, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Optometrist | 152W00000X | 1130919934 | UT | Primary |
Addresses
Primary practice location
914 Fort Union Blvd
Midvale, UT 84047-1714
Mailing address
914 Fort Union Blvd
Midvale, UT 84047-1714
Phone (801) 561-4282
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1130919934 | UT | MD | Optometrist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Mobileyes Optometry Inc | Optometrist | Past | Accepting new patients |
| Optometryprnpc | Optometrist | 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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1154563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1730197245",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "914 FORT UNION BLVD",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840471714",
"telephone_number": "801-561-4282",
"fax_number": "801-561-4283"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "914 FORT UNION BLVD",
"city": "MIDVALE",
"state": "UT",
"postal_code": "840471714",
"telephone_number": "801-561-4282",
"fax_number": "801-561-4283"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "DUANE",
"middle_name": "LEE",
"name_prefix": "Dr.",
"credential": "O.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-03",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "152W00000X",
"taxonomy_group": "",
"desc": "Optometrist",
"state": "UT",
"license": "1130919934",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Midvale, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.