Tanner Nielsen, DPT, PT

Primary specialty

Physical Medicine & Rehabilitation PhysicianTaxonomy code 208100000X

License

P22332 Issued in NC

Practice address

2310 Bale St
Raleigh, NC 27608-1771

Phone

(919) 364-4000

NPI assigned

Jul 13, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2022

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Moriarty Physical Therapy IncGroup PAC ID 8426391392, 5 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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.

• Moriarty Physical Therapy Inc

  • Physical Therapist
  • Raleigh, NC
  • NPI 1447715982
  Medicare reassignment Care Compare group NPD

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

{
    "created_epoch": "1689206400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689206400000",
    "number": "1770262271",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2310 BALE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081771",
            "telephone_number": "919-364-4000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2310 BALE ST",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "276081771",
            "telephone_number": "919-364-4000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NIELSEN",
        "first_name": "TANNER",
        "credential": "DPT, PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-07-13",
        "last_updated": "2023-07-13",
        "certification_date": "2023-07-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208100000X",
            "taxonomy_group": "",
            "desc": "Physical Medicine & Rehabilitation",
            "state": "NC",
            "license": "P22332",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lynn Margret Nicolaisen Degnan, PA-C
• Doris Maria Nicolas-Mir, RD
• Sarah Nidiffer
• Stephanie Gurganus Niedzwiecki, NP
• Carla Ludwigsen Nielsen
• Bruno Anthony Niemitz, LCSW, LMFT
• Haiyun Tang Niemzyk
• Donna Nienstedt, OTR
• Karla Nicole Nieves Borrero, M.D.
• Edith Maria Nieves Lopez, M.D.

• Physical Medicine & Rehabilitation Physician in Raleigh, NC
• Providers in Raleigh, NC by specialty
• Physical Medicine & Rehabilitation Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2023; 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.