Shaylon Tanner, LPN IV

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

LPN0000065644 Issued in TN

Practice address

295 Summar Dr
Jackson, TN 38301-3905

Phone

(731) 421-6783

NPI assigned

Oct 14, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

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": "1665705600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1665705600000",
    "number": "1750007365",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "219 W BROAD ST",
            "city": "DYER",
            "state": "TN",
            "postal_code": "383301403",
            "telephone_number": "731-337-8363"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "295 SUMMAR DR",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383013905",
            "telephone_number": "731-421-6783"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "SHAYLON",
        "credential": "LPN IV",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-10-14",
        "last_updated": "2022-10-14",
        "certification_date": "2022-10-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Licensed Practical Nurse",
            "state": "TN",
            "license": "LPN0000065644",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "laptop",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "295 Summar Dr",
            "city": "Jackson",
            "state": "TN",
            "country_code": "US",
            "postal_code": "383013905",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Amy B Talley, APN
• Angela Tamayo, LCSW
• Ashley N Tanner III, PHARMACIST
• Cathy Christine Tanner, LPC
• David J Tanner, PHARMACIST
• Andrew Tanyous, DDS
• Gerik Mark Tatarzycki, LCSW
• Cindy D Tate, RN
• Katherine Tate, OTR/L
• Norwood Tatman, OT

• Licensed Practical Nurse in Jackson, TN
• Providers in Jackson, TN by specialty
• Licensed Practical Nurse in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 14, 2022; 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.