MATTHEW JASON TANNER (NPI# 1396395067) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396395067 |
| Entity Type | Individual |
| Full Name | MATTHEW JASON TANNER |
| Practice Address |
1015 Michigan Ave Logansport IN 46947-1526 |
| Mailing Address |
3203 Susan Dr Kokomo IN 46902-7506 |
| Practice Telephone | 5747225151 |
| Mailing Telephone | 7654190610 |
| Enumeration Date | 2019-09-16 |
| Last Update Date | 2019-09-16 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363LP0808X |
Nurse Practitioner Specialization: Psych/Mental Health |
28177692A | IN | Physician Assistants & Advanced Practice Nursing Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144865056 | Matthew Tanner | Pharmacist | 646 Main St N, Pearson, GA 31642-7549 | 2019-11-14 |
| 1194380501 | Matthew A Tanner | Physician Assistant | 2001 Charlotte Ave, Nashville, TN 37203-2032 | 2019-05-01 |
| 1356876239 | Matthew Tanner | Student in an Organized Health Care Education/Training Program | 530 S Wakara Way, Salt Lake City, UT 84108-1213 | 2017-04-27 |
| 1811369994 | Matthew Tanner | Pharmacist | 890 Oak St Se, Salem, OR 97301-3905 | 2015-10-28 |
| 1154668432 | Matthew Alan Tanner | Counselor | 619 N 500 W, Provo, UT 84601-1547 | 2013-01-07 |
| Street Address |
1015 MICHIGAN AVE |
| City | LOGANSPORT |
| State | IN |
| Zip Code | 46947-1526 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1467434068 | Shawn G Larson | Psychiatry & Neurology | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2005-11-18 |
| 1649814872 | Sara Spence | Nurse Practitioner | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-10-31 |
| 1871136721 | Karen M Hatfield | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-10-23 |
| 1558911255 | Emily Anne Hollingsworth | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-09-13 |
| 1225682388 | Ankita Nikalje | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-07-27 |
| 1730733155 | Alainna Wen | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-07-25 |
| 1396399507 | Ryan Patrick Egan | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-07-25 |
| 1386298594 | Laura Jensen | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-07-25 |
| 1679126346 | Shereen Khoo | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-07-22 |
| 1770055147 | Margaret Blake Murray | Counselor | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2018-12-26 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578199345 | Stephanie Anne Dill | Family Medicine | 1101 Michigan Address, Logansport, IN 46947 | 2020-03-12 |
| 1023564259 | Wecare Tlc - Lcsc Health and Wellness | Clinic/Center | 2500 Hopper Street, Door C-13, Logansport, IN 46947 | 2016-08-28 |
| 1801266283 | Cheryl Lynn Ulery | Occupational Therapy Assistant | 5105 Northcrest Drive, Logansport, IN 46947 | 2015-09-29 |
| 1346618691 | Jan Hoover | Nurse Practitioner | 1025 Michigan Ave Ste 125, Logansport, IN 46947 | 2015-09-03 |
| 1922431741 | Ourhealth Physician Group, LLC | Clinic/Center | 99 E. Dewey St., Logansport, IN 46947 | 2013-08-15 |
| 1215245816 | Wal-mart Stores East Lp | Technician/Technologist | 240 Mall Road, Logansport, IN 46947 | 2010-09-16 |
| 1770778359 | Assisted Living Concepts Inc | Assisted Living Facility | 3901 High Street Road, Logansport, IN 46947 | 2007-09-07 |
| 1417152943 | Mary A Deinnocentes | Audiologist | 1325 N. 200 E., Logansport, IN 46947 | 2007-06-15 |
| 1396965018 | Elizabeth Dockerty Smith | Dentist | 335 Mall Road, Logansport, IN 46947 | 2007-04-26 |
| 1659599686 | Donna Beck Hermance | Physical Therapist | Northcentral Indiana Sports Center, 1603 Chase Road, Logansport, IN 46947 | 2007-04-23 |
| Find all providers in zip 46947 | ||||
| Taxonomy Code | 363LP0808X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Nurse Practitioner |
| Specialization | Psych/Mental Health |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649814872 | Sara Spence | Nurse Practitioner | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2019-10-31 |
| 1932648755 | Bonnie Miltenberger | Nurse Practitioner | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2017-02-13 |
| 1346671997 | Crystal Ridenour | Nurse Practitioner | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2013-12-09 |
| 1366616419 | Amy Herron-miller | Nurse Practitioner | 1015 Michigan Ave, Logansport, IN 46947-1526 | 2008-04-19 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548875669 | Brooke Lavignette | Nurse Practitioner | 1805 Summit Dr, West Lafayette, IN 47906-2231 | 2020-09-15 |
| 1205444775 | Anu Abraham Ade Owofadeju | Nurse Practitioner | 8820 S Meridian St Ste 225, Indianapolis, IN 46217-6064 | 2020-07-21 |
| 1356959068 | Indy Behavioral Health LLC | Nurse Practitioner | 2611 Waterfront Parkway East Dr Ste 370, Indianapolis, IN 46214-2069 | 2020-07-20 |
| 1942833306 | Osasumwen Igbinoba | Nurse Practitioner | 402 Wall St Ste 23, Valparaiso, IN 46383-2567 | 2020-02-13 |
| 1770114118 | Abbey Bolden | Nurse Practitioner | 929 Miller Ct, Greenfield, IN 46140-7267 | 2020-02-03 |
| 1376184556 | Carrie Mefford | Nurse Practitioner | 5435 E 16th St, Indianapolis, IN 46218-4869 | 2019-09-30 |
| 1700430006 | Lusine Vardanyan | Nurse Practitioner | Memorial Hospital and Health Care Center, 800 W 9th Street, Jasper, IN 47546-2514 | 2019-07-25 |
| 1134780851 | Eric Lyakhovetsky | Nurse Practitioner | 327 W Saidah Rd, Bloomington, IN 47404-8965 | 2019-06-24 |
| 1124599394 | Adria Dawn Thornburgh | Nurse Practitioner | 6235 Forest View Dr, Indianapolis, IN 46260-4707 | 2018-12-16 |
| 1033693213 | Katie Marie Feeney | Nurse Practitioner | Riley Children's Hospital, 705 Riley Hospital Dr, Indianapolis, IN 46202 | 2018-09-24 |
| Find all providers with the same taxonomy | ||||
| City | LOGANSPORT |
| Zip Code | 46947 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.