DONALD EDWIN TANNER (FNP-C) – Family Nurse Practitioner, NPI 1417738717

DONALD EDWIN TANNER (FNP-C) is a healthcare provider. based in Lees summit, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 2023041401 (MO). The NPI Number for DONALD EDWIN TANNER (FNP-C) is 1417738717

Main info

Male
Sole Proprietor
3 Years Of Experience
Accepts Medicare Assignment
Name
DONALD EDWIN TANNER (FNP-C)
NPI
1417738717
Phone
(816) 207-9099
Address
1120 NE BANNER DR
Enumeration Date
12 October 2023
Last Update Date
12 October 2023

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9072466155
Graduation Year
2023 (3 years ago)
PAC ID
0547606550
Group Practice PAC ID
3476690876
Professional Enrollment ID
I20240313001612
Address ID
AK996330211NA2XXXXRDXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience28
Completeness75
Years active:2State licenses:1Digital endpointsOther names

7,023 NURSE PRACTITIONER in MO

Provider Addresses for DONALD EDWIN TANNER (FNP-C)

  • 1120 NE BANNER DR

    LEES SUMMIT, MO 640866715

    Phone: (816) 207-9099

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

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: 2024-03-13

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20240313001612INurse PractitionerAKTBD

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.

Verify on CMS Revalidation Lookup Tool

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 64086)

Loading plans...

Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 3476690876View full group profile
NameSpecialtyState
-AK
Physician AssistantNC
Nurse PractitionerMO
Physician AssistantNH
Nurse PractitionerPA
-AK
-AK
Physician AssistantWI
Nurse PractitionerMO
Certified Nurse Midwife (Cnm)AK

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

What is the 10-digit NPI for DONALD EDWIN TANNER (FNP-C)?
DONALD EDWIN TANNER (FNP-C) — NPI 1417738717 — is the standard way to identify this listing.
Can I rely on DONALD EDWIN TANNER (FNP-C) being an active provider?
As of the registry snapshot, DONALD EDWIN TANNER (FNP-C) is marked active.
What taxonomy line describes DONALD EDWIN TANNER (FNP-C)?
For research purposes, treat DONALD EDWIN TANNER (FNP-C) as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What area does DONALD EDWIN TANNER (FNP-C) serve?
DONALD EDWIN TANNER (FNP-C)'s listing highlights Lees Summit, Missouri; more addresses can appear in NPPES.
Why does DONALD EDWIN TANNER (FNP-C) have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

Similar Providers

500, Southeast 3rd Terrace, Lee's Summit, Jackson County, Missouri, 64063, United States
NPI: 1033119938

JESSICA HOLLEY TWEEDY (MSN, CRNP)

Family Nurse Practitioner
7251 ENGLE RD STE 402
NPI: 1356341366

TAMERA J WOLF (FNP)

Family Nurse Practitioner
3265, Northeast Ralph Powell Road, Chapel Ridge Business Park, Lee's Summit, Jackson County, Missouri, 64064, United States
NPI: 1356342232
1741 NE Douglas St
NPI: 1205828670

MS. KRISTINE MARIE ROTTINGHAUS (FNP)

Family Nurse Practitioner
901, East 104th Street, Executive Hills East, Kansas City, Jackson County, Missouri, 64131, United States
NPI: 1104818483

TIWANA ALLEN (FNP)

Family Nurse Practitioner
Northeast Independence Avenue, Lee's Summit, Jackson County, Missouri, 64064, United States
NPI: 1851382063

MS. MICHELLE ANN GUINTA (MSN FNP-C)

Family Nurse Practitioner
141 W COMMERCIAL ST
NPI: 1962473215
329 SE CANTER CIR
NPI: 1821069980