Dustin James Tanner, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CH 10578 Issued in FL

Practice address

2200 N Ponce de Leon Blvd
Suite #1
St Augustine, FL 32084-2600

Phone

(904) 819-9110

Fax

(904) 819-9310

NPI assigned

Nov 5, 2009

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

Flagged The directory lists this NPI on an HHS exclusion list. The OIG exclusions file (LEIE) holds no record for this NPI, and the directory does not say which list the flag comes from. How exclusions are shown Confirm with the OIG exclusions search.

State licenses

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

{
    "created_epoch": "1257379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1338249600000",
    "number": "1790012201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD",
            "address_2": "SUITE #1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842600",
            "telephone_number": "315-224-4042",
            "fax_number": "904-819-9310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 N PONCE DE LEON BLVD",
            "address_2": "SUITE #1",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320842600",
            "telephone_number": "904-819-9110",
            "fax_number": "904-819-9310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "DUSTIN",
        "middle_name": "JAMES",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-11-05",
        "last_updated": "2012-05-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "FL",
            "license": "CH 10578",
            "primary": true
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NY",
            "license": "X012022-1",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Lara Tant, MA, R-DMT, RMHCI
• Edward Tanza Jr., DC
• Sarina Tarantino
• Gregory Tarantola, DDS
• Patricia A Taruski

• Chiropractor in St Augustine, FL
• Providers in St Augustine, FL by specialty
• Chiropractor in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 29, 2012; 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.