MR. CHRISTIAN DALE TANNER (FNP-C) – Family Nurse Practitioner, NPI 1790294007

MR. CHRISTIAN DALE TANNER (FNP-C) is a healthcare provider. based in Saint joseph, Missouri. specializing in NURSE PRACTITIONER. They hold the professional credentials FNP-C. They hold a License No. 2017035200 (MO). The NPI Number for MR. CHRISTIAN DALE TANNER (FNP-C) is 1790294007

Main info

Male
9 Years Of Experience
Accepts Medicare Assignment
Name
MR. CHRISTIAN DALE TANNER (FNP-C)
NPI
1790294007
Phone
(816) 238-7788
Address
5001 LAKE AVE
Enumeration Date
29 September 2017
Last Update Date
29 September 2017

Doctor Profile

Medical School Name
OTHER
Secondary Phone
8163969500
Graduation Year
2017 (9 years ago)
PAC ID
1658647334
Group Practice PAC ID
5294829248
Professional Enrollment ID
I20171024003407
Address ID
MO645065030SA4776XDRXX300
Data current as of
20 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience30
Completeness75
Years active:8State licenses:1Digital endpointsOther names

7,017 NURSE PRACTITIONER in MO

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Provider Addresses for MR. CHRISTIAN DALE TANNER (FNP-C)

  • 5001, Lake Avenue, St. Joseph, Buchanan County, Missouri, 64504, United States

    SAINT JOSEPH, MO 645041170

    Phone: (816) 238-7788

    Type: Location

  • 18400 SE HIGHWAY 371

    DEARBORN, MO 644398161

    Phone: (816) 210-6360

    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: 2017-10-24

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
I20171024003407INurse PractitionerMOTBD

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 64504)

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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: 5294829248View full group profile
NameSpecialtyState
Family PracticeMO
-MO
Nurse PractitionerKS
Emergency MedicineMO
Family Practice, Emergency MedicineMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerMO
Nurse PractitionerKS

Reviews

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Frequently asked questions

What is the 10-digit NPI for MR. CHRISTIAN DALE TANNER (FNP-C)?
MR. CHRISTIAN DALE TANNER (FNP-C) — NPI 1790294007 — is the standard way to identify this listing.
Is MR. CHRISTIAN DALE TANNER (FNP-C) still practicing?
MR. CHRISTIAN DALE TANNER (FNP-C) is currently listed as active in the public NPI registry.
What is MR. CHRISTIAN DALE TANNER (FNP-C) best known for clinically?
Directory data describes MR. CHRISTIAN DALE TANNER (FNP-C) with Family Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What address line appears for MR. CHRISTIAN DALE TANNER (FNP-C)?
MR. CHRISTIAN DALE TANNER (FNP-C)'s geographic hint is Saint Joseph, Missouri in our summary view.
Why does MR. CHRISTIAN DALE 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.

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