MR. PAUL BENJAMIN TANNER (NPI# 1760607428) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1760607428 |
Entity Type | Individual |
Full Name | MR. PAUL BENJAMIN TANNER |
Credential | MBA, CCA |
Practice Address |
3474 S 100 E Bountiful UT 84010-6605 |
Practice Telephone | 8019970545 |
Practice Fax Number | 8889775399 |
Mailing Telephone | 8019970545 |
Mailing Fax Number | 8889775399 |
Enumeration Date | 2007-04-16 |
Last Update Date | 2015-11-24 |
Gender Code | M |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
N | 224P00000X | Prosthetist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers | ||
N | 246ZA2600X |
Specialist/Technologist, Other Specialization: Art, Medical |
Technologists, Technicians & Other Technical Service Providers | ||
Y | 229N00000X | Anaplastologist | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1972635316 | Paul Lee Tanner | Dentist | 175 South Center Street, Duchesne, UT 84021-0477 | 2007-03-12 |
1508476888 | Paul Tanner | Case Manager/Care Coordinator | 201 22nd St, Ashland, KY 41101-7803 | 2020-08-03 |
1003921404 | Paul R Tanner | Radiology | 6019 Walnut Grove, Memphis, TN 38120 | 2006-08-19 |
Street Address |
3474 S 100 E |
City | BOUNTIFUL |
State | UT |
Zip Code | 84010-6605 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1255570099 | Custom Dme, LLC | Durable Medical Equipment & Medical Supplies | 3474 S 100 E, Bountiful, UT 84010-6605 | 2009-02-18 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1225699192 | Jessyca K Willie | Behavior Technician | 415 S. Medical Drive Suite D101, Bountiful, UT 84010 | 2019-06-21 |
1336634344 | Shanna Joy Jaggers | Social Worker | 2333 S 200 E, Bountiful, UT 84010 | 2018-06-22 |
1447773171 | Live Life Alarms | Emergency Response System Companies | 640 South 500 West, Bountiful, UT 84010 | 2017-07-25 |
1902328842 | Hailey Embley | Behavior Technician | 415 Medical Drive D 101, Bountiful, UT 84010 | 2017-07-12 |
1508318031 | Beverly Nielsen | Psychologist | 1001 Lakeview Drive, Bountiful, UT 84010 | 2016-11-01 |
1295287720 | Samantha Oslund | Speech-Language Pathologist | 415 Medical Dr Ste B102, Bountiful, UT 84010 | 2016-11-01 |
1750748273 | Jeremy Clark Morris | Dentist | 59 W 1600 N, Suite 110, Bountiful, UT 84010 | 2016-01-28 |
1629464706 | Shane James | Speech-Language Pathologist | 425 Medical Dr Ste 122, Bountiful, UT 84010 | 2015-04-15 |
1891186102 | Kenton Francis | Social Worker | 1355 North Main Street #1, Bountiful, UT 84010 | 2015-02-09 |
1205233855 | Modern Dental Professionals - Utah, PC | Dentist | 24 S. 500 West, #a, Bountiful, UT 84010 | 2014-11-25 |
Find all providers in zip 84010 |
Taxonomy Code | 229N00000X |
Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
Classification | Anaplastologist |
An anaplastologist is a professional who creates prostheses for the face and body. Patients treated include those missing anatomy due to cancer, traumatic injury, or birth differences. Generally, there are no state licensing requirements for anaplastologists. Certification specific to anaplastology is provided through the Board for Certified Clinical Anaplastology (BCCA) with a credential title of Certified Clinical Anaplastologist (CCA). |
Notes: Source: American Anaplastology Association, www.anaplastology.org. [7/1/2006: new] |
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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.