Jacob Farley Tanner, MS, ATC, LAT
NPI 1871016105ActiveIndividual· Specialist/Technologist, Athletic Trainer· Creve Coeur, MO
Specialist/Technologist, Athletic Trainer (MS, ATC, LAT) in Creve Coeur, Missouri, licensed in MO, with an NPI issued in July 2017.
Overview
| NPI | 1871016105 |
|---|---|
| Status | Active |
| Entity type | Individual |
| Credential | MS, ATC, LAT |
| Sole proprietor | Yes |
| NPI issued | Jul 19, 2017 |
| Last updated in NPPES | Aug 3, 2017 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Specialist/Technologist, Athletic Trainer Primary | 2255A2300X | 2015026272 | MO |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Not in the public enrollment file of Oct 1, 2026 |
|---|
Other Specialist/Technologist, Athletic Trainer providers in Creve Coeur
- 1205870433
- 1760756126
- 1285089607
- 1043744188
- 1497293435
- 1114315140
- 1124418603
- 1558895086
All Specialist/Technologist, Athletic Trainer providers in Missouri →