Active NPI
Tanner Jesse Harmon, M.D.
- Diagnostic Radiology Physician
- Provo, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Diagnostic Radiology Physician
- License
- 12745075-1205
- Practice address
- 1055 N 500 W Ste 112
Provo, UT 84604-3305 - Phone
- (801) 812-4624
- Fax
- (801) 812-4699
- NPI assigned
- Apr 1, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diagnostic Radiology Physician | 2085R0202X | 12745075-1205 | UT | Primary |
Addresses
Primary practice location
1055 N 500 W Ste 112
Provo, UT 84604-3305
Mailing address
1055 N 500 W
Attn Credentialing
Provo, UT 84604
Phone (801) 354-8225
Other practice location 1
1175 E 50 S Ste 221
American Fork, UT 84003-2845
Phone (801) 492-5996
Other practice location 2
2825 E Mall Dr
St George, UT 84790-1954
Phone (435) 986-2238
Other practice location 3
555 W State Road 164
Salem, UT 84653-5732
Phone (801) 812-4624
Other practice location 4
3000 N Triumph Blvd
Lehi, UT 84043-7186
Phone (385) 345-3155
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | credentialing@reverehealth.com | Central Utah Clinic, P.C. |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Diagnostic Radiology
- Education
- University of Utah School of Medicine, 2015
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
1055 N 500
Provo, UT 84604-3305
Phone (801) 812-4624
Hospital & facility affiliations
- Central Valley Medical Center - Cah
- Timpanogos Regional Hospital
- Holy Cross Hospital-Jordan Valley
- Mountain View Hospital
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Revere Health PC | Current | Accepting new patients | |
| Revere Health PC | Current | Accepting new patients |
Locations
1175 E 50 S
Ste 141
American Fork, UT 84003
Phone (801) 492-5996
1175 E 50 S
Ste 112
American Fork, UT 84003
1175 E 50 S
Ste 221
American Fork, UT 84003
Phone (801) 772-0775
3000 N Triumph Blvd
Lehi, UT 84043
Phone (385) 345-3000
3000 N Triumph Blvd
Ste 112
Lehi, UT 84043
3000 N Triumph Blvd
Ste 100
Lehi, UT 84043
Phone (385) 345-3155
1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
1055 N 500 W
Ste 112
Provo, UT 84604
Phone (801) 812-4624
555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896
2825 E Mall Dr
Ste 112
St George, UT 84790
2825 E Mall Dr
St George, UT 84790
Phone (435) 673-6131
Interoperability endpoints
- tannerharmon@cuccu.allscriptsdirect.net
Organizations & group practices 2
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.
-
- Multi-Specialty Clinic/Center
- Provo, UT
- NPI 1093764805
-
- Multi-Specialty Clinic/Center
- Spanish Fork, UT
- NPI 1851142285
Hospital & facility affiliations 5
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- General Acute Care Hospital
- West Jordan, UT
- NPI 1801591391
-
- Critical Access Hospital
- Nephi, UT
- NPI 1881658110
-
- General Acute Care Hospital
- Payson, UT
- NPI 1487607669
-
- General Acute Care Hospital
- Orem, UT
- NPI 1497702195
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1427846400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1742860800000",
"number": "1821483389",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1055 N 500 W",
"address_2": "ATTN CREDENTIALING",
"city": "PROVO",
"state": "UT",
"postal_code": "84604",
"telephone_number": "801-354-8225",
"fax_number": "801-418-0941"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1055 N 500 W STE 112",
"city": "PROVO",
"state": "UT",
"postal_code": "846043305",
"telephone_number": "801-812-4624",
"fax_number": "801-812-4699"
}
],
"practiceLocations": [
{
"address_1": "1175 E 50 S Ste 221",
"address_purpose": "LOCATION",
"city": "American Fork",
"state": "UT",
"postal_code": "840032845",
"country_code": "US",
"telephone_number": "801-492-5996",
"fax_number": "801-492-5993",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "2825 E Mall Dr",
"address_purpose": "LOCATION",
"city": "St George",
"state": "UT",
"postal_code": "847901954",
"country_code": "US",
"telephone_number": "435-986-2238",
"fax_number": "435-986-2237",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "555 W State Road 164",
"address_purpose": "LOCATION",
"city": "Salem",
"state": "UT",
"postal_code": "846535732",
"country_code": "US",
"telephone_number": "801-812-4624",
"fax_number": "801-812-4699",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "3000 N Triumph Blvd",
"address_purpose": "LOCATION",
"city": "Lehi",
"state": "UT",
"postal_code": "840437186",
"country_code": "US",
"telephone_number": "385-345-3155",
"fax_number": "385-345-3163",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "HARMON",
"first_name": "TANNER",
"middle_name": "JESSE",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-04-01",
"last_updated": "2025-03-25",
"certification_date": "2025-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "2085R0202X",
"taxonomy_group": "",
"desc": "Radiology, Diagnostic Radiology",
"state": "UT",
"license": "12745075-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "credentialing@reverehealth.com",
"affiliation": "Y",
"affiliationName": "Central Utah Clinic, P.C.",
"address_1": "1055 N 500 W",
"city": "Provo",
"state": "UT",
"country_code": "US",
"postal_code": "846043305",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- 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.