Glen J Tanner, D.C.

Primary specialty

Rehabilitation ChiropractorTaxonomy code 111NR0400X

License

5739 Issued in AZ

Practice address

34597 N 60TH St
Scottsdale, AZ 85262-5240

Phone

(480) 595-6100

Fax

(480) 595-6102

NPI assigned

Dec 14, 2006

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 identifiers 1

Medicare fee-for-service enrollment

Enrolled in AZ

Enrollment records 1

Specialty

Chiropractic

Education

Palmer College Chiropractic - West Sunnyvale, 1995

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Tanner Chiropractic, PLLC

  • Chiropractor
  • Scottsdale, AZ
  • NPI 1194262766
  Medicare reassignment Authorized official
• Jeffrey D Clark D D S P C

  • Dentist
  • Scottsdale, AZ
  • NPI 1184829053
  NPD

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1942362330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6795 E EAGLE FEATHER RD",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852627360",
            "telephone_number": "480-703-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "34597 N 60TH ST",
            "city": "SCOTTSDALE",
            "state": "AZ",
            "postal_code": "852625240",
            "telephone_number": "480-595-6100",
            "fax_number": "480-595-6102"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "GLEN",
        "middle_name": "J",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0400X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Rehabilitation",
            "state": "AZ",
            "license": "5739",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "AZ0244750",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Poliana Chu Tan, MD
• Wen D Tan, PA-C
• Simeon H Tang, PHARM.D.
• Scott P Tannehill, MD
• Tanner Chiropractic, PLLC
• Jon M Tanner, D.C.
• Vanessa Elayne Tanner I, LCSW
• Nicole Tansy
• Tao Acupuncture Clinic
• Alana Jane Tao, PT, DPT

• Rehabilitation Chiropractor in Scottsdale, AZ
• Providers in Scottsdale, AZ by specialty
• Rehabilitation Chiropractor in Arizona

• 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.
• 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.