Mark A Tanner, P.A.-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

PA00315 Issued in TX

Practice address

4201 Bee Cave Rd
Suite 102
West Lake Hills, TX 78746-6465

Phone

(512) 301-1712

NPI assigned

Apr 20, 2007

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

Other names 1

• Mr. Mark A. Tanner Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

HHS exclusion list flag

CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found. 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.

Credentials

Physician Assistant

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

{
    "created_epoch": "1177027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1932326873",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4307 SENDERO DR",
            "city": "AUSTIN",
            "state": "TX",
            "postal_code": "787356321",
            "telephone_number": "213-892-2257"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 BEE CAVE RD",
            "address_2": "SUITE 102",
            "city": "WEST LAKE HILLS",
            "state": "TX",
            "postal_code": "787466465",
            "telephone_number": "512-301-1712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "MARK",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "P.A.-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "TX",
            "license": "PA00315",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARK",
            "last_name": "TANNER",
            "middle_name": "A.",
            "prefix": "MR.",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Donald Scott Sweeney, DC
• Patrick J. Swint, MS, PA-C
• Synova Health
• Amir Tadros, DDS, MD
• Uri Talmor, MA, LPC
• Tao Blossom PLLC (Tao Blossom)
• Tara Sen Counseling PLLC
• Yekaterina Taylor
• Teahouse Counseling
• Ted L Edwards Jr MD PA (The Hills Medical Group)

• Medical Physician Assistant in West Lake Hills, TX
• Providers in West Lake Hills, TX by specialty
• Medical Physician Assistant in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.