TANNER PRIMARY CARE OF ROANOKE INC – Rural Health Clinic/Center, NPI 1255899092
Rural Health Clinic/Center
Main info
Profile Insights
NPPES metrics only — not quality of care.
Provider Addresses for TANNER PRIMARY CARE OF ROANOKE INC
965 HIGHWAY 431
ROANOKE, AL 362747329
Phone: (334) 863-2141
Fax: (334) 863-8733
Type: Location
Ambulance Drive, Carrollton, Carroll County, Georgia, 30119, United States
CARROLLTON, GA 301173857
Phone: (770) 838-8710
Fax: (770) 838-8563
Type: Mailing
100 GREENWAY BLVD FL 2
CARROLLTON, GA 301174338
Phone: (770) 838-8710
Fax: (770) 812-5735
Type: Mailing
706 DIXIE ST STE 220
CARROLLTON, GA 301173889
Phone: (770) 838-8710
Fax: (770) 812-5735
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: 2019-11-18
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2024-04-30 (770 days ago).
Enrollment records
2
Earliest due date
2024-04-30
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 |
|---|---|---|---|---|
| O20190425001408 | O | Clinic/Group Practice | AL | 2024-04-30 |
| O20191118001973 | O | Rural Health Clinic | AL | 2025-07-31 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
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 36274)
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