Colby Tanner

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-176000 Issued in AL

Practice address

4370 W Main St
Dothan, AL 36305-1056

Phone

(334) 793-5000

NPI assigned

Jan 24, 2024

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 AL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: colbytanner@dpc.allscriptsdirect.net

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.

• Dothan Pediatric Clinic, P. a.

  • Pediatrics Physician
  • Dothan, AL
  • NPI 1376508788

  Family

  Medicare reassignment NPD

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

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1706054400000",
    "number": "1821850983",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 PEACOCK ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363016341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4370 W MAIN ST",
            "city": "DOTHAN",
            "state": "AL",
            "postal_code": "363051056",
            "telephone_number": "334-793-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "COLBY",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-176000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Synapses Lab LLC
• T M Supply Inc
• Jeffrey M. Tamburin, M.D.
• Laura M Tamburin, MD
• Tami S. Jordan
• Stella Elizabeth Tanner
• Fateeha Tariq
• Erica Elizabeth Tarrant, LICSW
• Samuel Joseph Tarwater, MD
• Andria Daryn Tate

• Family Nurse Practitioner in Dothan, AL
• Providers in Dothan, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.