John Calvin Tanner, DO

Primary specialty

Addiction Medicine (Psychiatry & Neurology) PhysicianTaxonomy code 2084A0401X

License

OS4709 Issued in FL

Practice address

340 16TH Ave N Ste a
Jacksonville Beach, FL 32250-4819

Phone

(904) 241-2653

Fax

(904) 758-0559

NPI assigned

Jun 23, 2006

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 3

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Enrolled in FL

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Addiction Medicine

Education

Philadelphia College of Osteopathic Medicine, 1983

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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 Medical Enterprises, Inc

  • Addiction Medicine (Family Medicine) Physician
  • Neptune Beach, FL
  • NPI 1508185190
  Medicare reassignment NPD

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747353600000",
    "number": "1952337990",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 51595",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322401595",
            "telephone_number": "904-571-9439",
            "fax_number": "904-758-0559"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 16TH AVE N STE A",
            "city": "JACKSONVILLE BEACH",
            "state": "FL",
            "postal_code": "322504819",
            "telephone_number": "904-241-2653",
            "fax_number": "904-758-0559"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "JOHN",
        "middle_name": "CALVIN",
        "name_prefix": "Dr.",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2025-05-16",
        "certification_date": "2025-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "FL",
            "license": "OS0004709",
            "primary": false
        },
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "FL",
            "license": "OS0004709",
            "primary": false
        },
        {
            "code": "2084A0401X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Addiction Medicine",
            "state": "FL",
            "license": "OS4709",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "010659200",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "068895900",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RAILROAD",
            "identifier": "080025596",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "82622",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Molly E Szczepanik
• Sarah Szymanski, OTR/L
• Talton Chiropractic Clinic LLC
• Richard James Talton, D.C.
• Jose Raphael G Tamayo, MD
• Millicent Tanner, R.D.,C.D.E.
• Staci L Tanouye, M.D.
• Telepsychiatric Bridge Services
• Maryori Yuldana Tello, RD, LDN, CDM, CFPP
• Tender Chiropractic Health Center PA

• Addiction Medicine (Psychiatry & Neurology) Physician in Jacksonville Beach, FL
• Providers in Jacksonville Beach, FL by specialty
• Addiction Medicine (Psychiatry & Neurology) Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 16, 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.

Verify at the official NPI Registry.