Paul Benjamin Tanner, MBA, CCA

Primary specialty

AnaplastologistTaxonomy code 229N00000X

Practice address

1455 S 500 W Ste D
Bountiful, UT 84010-8252

Phone

(801) 997-0545

Fax

(888) 977-5399

NPI assigned

Apr 16, 2007

Sex

Male

Sole proprietor

No

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

Specialties & licenses 4

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Business Administration

Practice roles

Locations

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.

• Custom DME

  • Anaplastologist
  • Bountiful, UT
  • NPI 1255570099

  Ocularist

  NPD Authorized official

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

{
    "created_epoch": "1176681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1760607428",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3474 S 100 E",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840106605",
            "telephone_number": "801-997-0545",
            "fax_number": "888-977-5399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1455 S 500 W STE D",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840108252",
            "telephone_number": "801-997-0545",
            "fax_number": "888-977-5399"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "PAUL",
        "middle_name": "BENJAMIN",
        "credential": "MBA, CCA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-16",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "156FX1700X",
            "taxonomy_group": "",
            "desc": "Technician/Technologist, Ocularist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224P00000X",
            "taxonomy_group": "",
            "desc": "Prosthetist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "246ZA2600X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Other, Art, Medical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "229N00000X",
            "taxonomy_group": "",
            "desc": "Anaplastologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Switzer Medical TX, PLLC
• Michelle Miner Taggart, M.S./CCC
• Rachel Taggart, CTRS, TRS
• Betty Talo
• Kylie Nichole Tanner
• Shonn J Tanner, DPT
• Ana Taulanga
• Tautai Barton Creek, LLC
• Mary Frances Tay, RDN
• Ashley Taylor

• Anaplastologist in Bountiful, UT
• Providers in Bountiful, UT by specialty
• Anaplastologist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; 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.