Individual provider Active NPI

Rachel Lynn Tanner, OD

  • Optometrist
  • Spartanburg, SC
National Provider Identifier
1730562596
Registry record updated May 18, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
OptometristTaxonomy code 152W00000X
License
1892 Issued in SC
Practice address
1855 E Main St Ste 12
Spartanburg, SC 29307-2326
Phone
(864) 308-8812
NPI assigned
Jun 29, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 18, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Optometrist 152W00000X 1892 SC Primary

Addresses

Primary practice location

1855 E Main St Ste 12
Spartanburg, SC 29307-2326

Mailing address

1855 E Main St Ste 12
Spartanburg, SC 29307-2326
Phone (864) 308-8812

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20161011003203 SC Practitioner - Optometry 3274821004 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Optometry
Education
University of Alabama School of Medicine, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Bella Vision LLCGroup PAC ID 1254562515, 2 clinicians

Practice addresses (Care Compare)

142 Fernwood Dr
Spartanburg, SC 29307-2229
Phone (864) 308-8812

Procedures performed for Medicare patients

ProcedureNumber of procedures
Cataract surgery22

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bella Vision, LLC Optometrist CurrentSince Jan 3, 2022 Accepting new patients
F Mason Smith Optometrist Past Accepting new patients

Locations

1855 E Main St
Ste 12
Spartanburg, SC 29307
Phone (864) 308-8812

142 Fernwood Dr
Spartanburg, SC 29307
Phone (864) 308-8812

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1435536000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1652832000000",
    "number": "1730562596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1855 E MAIN ST STE 12",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072326",
            "telephone_number": "864-308-8812"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1855 E MAIN ST STE 12",
            "city": "SPARTANBURG",
            "state": "SC",
            "postal_code": "293072326",
            "telephone_number": "864-308-8812"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "RACHEL",
        "middle_name": "LYNN",
        "credential": "OD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-29",
        "last_updated": "2022-05-18",
        "certification_date": "2022-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "152W00000X",
            "taxonomy_group": "",
            "desc": "Optometrist",
            "state": "SC",
            "license": "1892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Spartanburg, SC

Sources for this page

Verify at the official NPI Registry.