Active NPI
Kristin J Tanner
- Clinical Social Worker
- Joplin, MO
National Provider Identifier
1902412174
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 2020030916
- Practice address
- 530 E 34TH St
Joplin, MO 64804-3926 - Phone
- (417) 347-7630
- NPI assigned
- Sep 22, 2020
- Last updated
- Jun 10, 2021
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 2020030916 | MO | Primary |
Addresses
Primary practice location
530 E 34TH St
Joplin, MO 64804-3926
Mailing address
PO Box 2526
Joplin, MO 64803-2526
Phone (417) 347-7579
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2020030916 | MO | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ozark Center | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1600732800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1623283200000",
"number": "1902412174",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2526",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648032526",
"telephone_number": "417-347-7579"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "530 E 34TH ST",
"city": "JOPLIN",
"state": "MO",
"postal_code": "648043926",
"telephone_number": "417-347-7630"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANNER",
"first_name": "KRISTIN",
"middle_name": "J",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2020-09-22",
"last_updated": "2021-06-10",
"certification_date": "2021-06-10",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "MO",
"license": "2020030916",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Joplin, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.