NPIMap

Organization Active NPI

Tanner Memorial Clinic

Doing business as Tanner Clinic

  • Family Medicine Physician
  • Layton, UT
National Provider Identifier
1760934533
Registry record updated Jan 20, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
162143-1205 Issued in UT
Legal business name
TANNER MEMORIAL CLINIC
Doing business as
Tanner Clinic
Practice address
1750 E 3100 N
Layton, UT 84040
Phone
(801) 773-4840
NPI assigned
Oct 27, 2016
Last updated
Jan 20, 2020By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 20, 2020

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

Authorized official

Name
Jay Yates, M.D.NPI 1427034297
Title
President
Phone
(801) 773-4840

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 162143-1205 UT Primary

Addresses

Primary practice location

1750 E 3100 N
Layton, UT 84040

Mailing address

2121 N 1700 W
Layton, UT 84041-8803
Phone (801) 773-4840

Other names 1

  • Tanner Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20031110000132 UT Part B Supplier - Clinic/Group Practice 4284547985 Receives reassigned benefits from 314 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Syracuse, UT; Roy, UT; Ogden, UT; Murray, UT; Layton, UT; Kaysville, UT; Farmington, UT; Clinton, UT

Other NPIs on the same Medicare enrollment 10

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2121334Tanner Clinic - East1750 E 3100 N, Layton, UT 84040ComplianceOct 30, 2027

National Provider Directory

National Provider Directory

Locations

380 N 400 W
Kaysville, UT 84037
Phone (801) 547-9500

1660 W Antelope Dr
Layton, UT 84041
Phone (801) 525-8726

Practitioners & affiliated clinicians

Practitioners 90

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 90

NPI Registry JSON

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

{
    "created_epoch": "1477526400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579478400000",
    "number": "1760934533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 N 1700 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840418803",
            "telephone_number": "801-773-4840"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 E 3100 N",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84040",
            "telephone_number": "801-773-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANNER MEMORIAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-10-27",
        "last_updated": "2020-01-20",
        "certification_date": "2020-01-20",
        "status": "A",
        "authorized_official_last_name": "YATES",
        "authorized_official_first_name": "JAY",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-773-4840",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "162143-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Tanner Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Layton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 20, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.