TRAVIS TANNER (NPI# 1871947796) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1871947796 |
| Entity Type | Individual |
| Full Name | TRAVIS TANNER |
| Credential | PHARMD |
| Practice Address |
3535 Southern Blvd Kettering OH 45429-1221 |
| Practice Telephone | 9372983399 |
| Enumeration Date | 2016-04-18 |
| Last Update Date | 2016-04-18 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 1835C0205X |
Pharmacist Specialization: Critical Care |
03124637 | OH | Pharmacy Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1861005217 | Travis Tanner | Behavior Technician | 6961 University Blvd, Winter Park, FL 32792-6710 | 2020-08-26 |
| 1811371727 | Travis Tanner | Social Worker | 225 W 35th St Fl 7, New York, NY 10001-1904 | 2015-07-10 |
| Street Address |
3535 SOUTHERN BLVD |
| City | KETTERING |
| State | OH |
| Zip Code | 45429-1221 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134124183 | David M Brouhard | Anesthesiology | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2005-06-16 |
| 1245846757 | Rachel Henderson | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-09-21 |
| 1235745043 | Nipa Mukesh Patel | Pharmacist | 3535 Southern Blvd, Kettering, OH 45429-1298 | 2020-09-17 |
| 1104437425 | Stephanie Elizabeth Nicholls | Hospitalist | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-08-11 |
| 1346865144 | Anesthesia Pearls, LLC | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1568087351 | Pearl Lee | Nurse Anesthetist, Certified Registered | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-06-08 |
| 1922631761 | Michael Patrick Lorey | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2020-02-20 |
| 1801446315 | Madison A Tate | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-09-17 |
| 1962058966 | Joshua Caleb Courlas | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-15 |
| 1134775273 | Jason Raymond Leigh | Physician Assistant | 3535 Southern Blvd, Kettering, OH 45429-1221 | 2019-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821576414 | Lauren Danielle Sivley | Nurse Practitioner | 3535 Sourthern Boulevard, Kettering, OH 45429 | 2018-08-06 |
| 1114446127 | Louai Al-samkari | Chiropractor | 1441 E. Stroop Rd., Kettering, OH 45429 | 2017-09-12 |
| 1407373756 | Benjamin Edward Adkins | Specialist/Technologist | 4116 Vinita Dr., Kettering, OH 45429 | 2017-08-28 |
| 1972036341 | James Kim | Student in an Organized Health Care Education/Training Program | 3535 Southern Boulevard, Kettering, OH 45429 | 2017-04-04 |
| 1023549847 | Adrienne Krysiak | Emergency Medicine | 3525 Southern Boulevard, Kettering, OH 45429 | 2017-03-23 |
| 1386021889 | Cassandra Mckoy | Counselor | 529 East Stroop Road, Kettering, OH 45429 | 2015-05-04 |
| 1417343088 | Candace Benoit | Obstetrics & Gynecology | 3533 Southern Blvd Ste 4600, Dayton, OH 45429 | 2015-04-10 |
| 1275933574 | Lee Schwieterman | Nurse Practitioner | 3535 Southern Blvd., 1 East, Kettering, OH 45429 | 2014-08-25 |
| 1497161947 | Robert Jonathon Fresch Jr. | Obstetrics & Gynecology | 3533 Southern Blvd Ste 3750, Kettering, OH 45429 | 2014-07-05 |
| 1821349812 | Lucas Brewer | Counselor | 1524 E Stroop Rd Ste 300, Kettering, OH 45429 | 2012-10-01 |
| Find all providers in zip 45429 | ||||
| Taxonomy Code | 1835C0205X |
| Grouping | Pharmacy Service Providers |
| Classification | Pharmacist |
| Specialization | Critical Care |
| A licensed pharmacist who has demonstrated specialized knowledge and skill in the delivery of patient care services by pharmacists, as integral members of interprofessional teams, working to ensure the safe and effective use of medications in critically ill patients. |
| Notes: Source: Board of Pharmacy Specialties, www.bpsweb.org [1/1/2016: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1447869433 | David Mark Peters Jr. | Pharmacist | 1 Wyoming St, Dayton, OH 45409-2722 | 2020-07-27 |
| 1851927032 | Suzanne Van Fleet | Pharmacist | 7700 University Dr, West Chester, OH 45069-2505 | 2020-03-19 |
| 1912557422 | Nathanael Smith | Pharmacist | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-09-17 |
| 1851946768 | Nick Wolters | Pharmacist | 405 W Grand Ave, Dayton, OH 45405-7538 | 2019-08-07 |
| 1508327511 | Alia Anne Poore | Pharmacist | 18101 Lorain Ave, Cleveland, OH 44111-5612 | 2019-03-31 |
| 1629558747 | Joshua Arnold | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2018-08-17 |
| 1447745856 | Jaimini Sandip Patel | Pharmacist | 1 Akron General Ave, Akron, OH 44307-2432 | 2018-06-27 |
| 1780195222 | Logan Olson | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2017-10-23 |
| 1558871129 | Brittany Rae Kiracofe | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2017-10-09 |
| 1821543364 | Molly Jean Thompson | Pharmacist | 410 W 10th Ave, Columbus, OH 43210-1240 | 2016-08-24 |
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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.