TANNER MEDICAL ENTERPRISES, INC (NPI# 1508185190) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1508185190 |
| Entity Type | Organization |
| Organization Name | TANNER MEDICAL ENTERPRISES, INC |
| Practice Address |
101 Florida Blvd Neptune Beach FL 32266-4966 |
| Mailing Address |
Po Box 51595 Jacksonville Beach FL 32240-1595 |
| Practice Telephone | 9042412653 |
| Practice Fax Number | 9042466312 |
| Mailing Telephone | 9042412653 |
| Mailing Fax Number | 9042466312 |
| Enumeration Date | 2010-05-23 |
| Last Update Date | 2013-03-04 |
| Authorized Official Name | MILLICENT H TANNER (ADMINISTRATOR/OWNER) |
| Authorized Official Telephone | 9042412653 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207Q00000X | Family Medicine | OS4709 | FL | Allopathic & Osteopathic Physicians |
| N | 2084P0802X |
Psychiatry & Neurology Specialization: Addiction Psychiatry |
OS4709 | FL | Allopathic & Osteopathic Physicians |
| Y | 207QA0401X |
Family Medicine Specialization: Addiction Medicine |
OS4709 | FL | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| FL | 068895900 | 05 | |
| FL | BCBS | 82622 | 01 |
| Street Address |
101 FLORIDA BLVD |
| City | NEPTUNE BEACH |
| State | FL |
| Zip Code | 32266-4966 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174098057 | Margaret Elizabeth Bernhart | Counselor | 800 3rd Street Ste C, Neptune Beach, FL 32266 | 2018-10-08 |
| 1144707753 | Matthew Hickman | Counselor | 804 3rd St Suite Ab, Neptune Beach, FL 32266 | 2018-07-26 |
| 1487172094 | Seabreeze Medical Pa | Internal Medicine | 320 3rd St Ste B, Neptune Beach, FL 32266 | 2017-09-03 |
| 1740714716 | Christine Coleman | Counselor | 804 3rd St Ste A&b, Neptune Beach, FL 32266 | 2017-04-17 |
| 1609227685 | Susan E. Stewart | Acupuncturist | 320 Third Street, Sutie B, Neptune Beach, FL 32266 | 2016-06-30 |
| 1407203078 | Lofton Creek Dental, Pa | Dentist | 109 Azalea Place, Neptune Beach, FL 32266 | 2016-05-24 |
| 1083082895 | Edith Maria Ortega | Internal Medicine | 528 Oceanfront, Neptune Beach, FL 32266 | 2015-09-10 |
| 1689074817 | Elizabeth Phillips Broullire | Pharmacist | 630 Atlantic Blvd., Neptune Beach, FL 32266 | 2014-08-25 |
| 1740614775 | Surfside Dental Center, Pa. | Point of Service | 630-7 Atlantic Blvd., Neptune Beach, FL 32266 | 2013-08-27 |
| 1568725984 | Neptune Beach Pharmacy LLC | Pharmacist | 1529 Atlantic Blvd, Neptune Beach, FL 32266 | 2012-06-20 |
| Find all providers in zip 32266 | ||||
| Taxonomy Code | 207QA0401X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Specialization | Addiction Medicine |
| A family medicine physician who specializes in the diagnosis and treatment of addictions. |
| Notes: Source: National Uniform Claim Committee, 2009 [1/1/2010: definition added, source added] Additional Resources: A Certification of Added Qualifications (CAQ) was, but is no longer issued by the American Osteopathic Board of Family Physicians. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649895095 | Bdmj Holdings | Family Medicine | 2150 Lake Ida Rd Ste 2, Delray Beach, FL 33445-2443 | 2020-06-11 |
| 1932730942 | Freeport Medical Associates | Family Medicine | 17256 Main St N Ste 1, Blountstown, FL 32424-1775 | 2020-01-29 |
| 1649822867 | Medical Partners of The Palm Beaches | Family Medicine | 2600 Quantum Blvd Bldg A, Boynton Beach, FL 33426-8627 | 2019-07-09 |
| 1780247064 | Pinnacle Rehabilitation Group | Family Medicine | 1680 Se Lyngate Dr Ste 204, Port Saint Lucie, FL 34952-4300 | 2019-04-22 |
| 1518441252 | Solstice Health and Wellness, LLC | Family Medicine | 1219 S East Ave South, Suite C204, Sarasota, FL 34239-2340 | 2018-09-19 |
| 1063956761 | Inspirations Recovery Center, LLC | Family Medicine | 5208 10th Ave N, Greenacres, FL 33463-2053 | 2016-12-14 |
| 1003365800 | Family First | Family Medicine | 5220 Hood Road, Suite 100, Palm Beach Gardens, FL 33418-8910 | 2016-09-22 |
| 1396290409 | Aquarius Physicians Group | Family Medicine | 749 Us Highway 1, Suite 210, North Palm Beach, FL 33408-4400 | 2016-08-18 |
| 1861823452 | Parthenon Behavioral Center | Family Medicine | 5101 Bowden Road, Jacksonville, FL 32216 | 2013-12-06 |
| 1457697278 | South Walton Medical Group | Family Medicine | 10065 Us Highway 98 W Ste B101, Miramar Beach, FL 32550-1902 | 2012-12-26 |
| Find all providers with the same taxonomy | ||||
| City | NEPTUNE BEACH |
| Zip Code | 32266 |
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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.