JACKIE R TANNER (ARNP) – Nurse Practitioner, NPI 1609229343
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
24,232 NURSE PRACTITIONER in FL
Provider Addresses for JACKIE R TANNER (ARNP)
6850 NEW TAMPA HWY
LAKELAND, FL 338153168
Phone: (863) 583-7100
Type: Location
1558 DOVES VIEW CIR
AUBURNDALE, FL 338232753
Phone: (863) 206-7969
Type: Mailing
638 HARRISON AVE STE 102
PANAMA CITY, FL 324012662
Phone: (850) 558-4400
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2026-03-13
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking 2 Medicare enrollment records; no due dates published yet.
Enrollment records
2
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20160927000749 | I | Nurse Practitioner | FL | TBD |
| I20260313001799 | I | Nurse Practitioner | AL | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 33815)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| U R O L O G Y | AL | |
| Emergency Medicine | MI | |
| - | AL | |
| - | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Internal Medicine | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| U R O L O G Y | AL | |
| Certified Registered Nurse Anesthetist (Crna) | AL | |
| Critical Care (Intensivists) | AL |
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