Robert Wynne Tennant, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

492 Issued in IN

Practice address

1471 Jason Rd
Ste 100
Greenfield, IN 46140-1097

Phone

(765) 737-1117

Fax

(765) 737-1119

NPI assigned

Sep 19, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IN

Enrollment records 1

Specialty

Chiropractic

Education

National College of Chiropractic, 1973

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1127088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1640217600000",
    "number": "1790770485",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1471 JASON RD",
            "address_2": "STE 100",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401097",
            "telephone_number": "765-737-1117",
            "fax_number": "765-737-1119"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1471 JASON RD",
            "address_2": "STE 100",
            "city": "GREENFIELD",
            "state": "IN",
            "postal_code": "461401097",
            "telephone_number": "765-737-1117",
            "fax_number": "765-737-1119"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TENNANT",
        "first_name": "ROBERT",
        "middle_name": "WYNNE",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-09-19",
        "last_updated": "2021-12-23",
        "certification_date": "2021-12-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "IN",
            "license": "492",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM",
            "identifier": "000000096713",
            "state": null
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100127340A",
            "state": "IN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Chiropractor in Greenfield, IN
• Providers in Greenfield, IN by specialty
• Chiropractor in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2021; 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.