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ALICE TANNER M.D.,PC
NPI 1013184159
Pediatrics - Adolescent Medicine in Glen Burnie, MD

Active since May 08, 2008CLIA 21D0927258 · Waiver
1406 CRAIN HWY S, SUITE 104, GLEN BURNIE, MD 21061(410) 768-2231(410) 760-4522 Get Directions Write a Review

NPPES record last updated: May 8, 2008. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Alice Tanner M.d.,pc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

ALICE TANNER M.D.,PC (NPI 1013184159) is a healthcare organization registered as an adolescent medicine in Glen Burnie, Maryland and active in the NPI registry since May 2008. The organization holds a CLIA Waiver certificate valid through April 13, 2027 and lists Alice Patricia Tanner, Pediatrician/practice Owner, as its authorized official.

NPPES Registry Identity

NPI1013184159
Entity TypeOrganization
Primary Taxonomy2080A0000X
Legal Business NameALICE TANNER M.D.,PC
Location Address1406 CRAIN HWY S, SUITE 104Glen Burnie, MD 21061-4058
Mailing Address1406 Crain Hwy S, Suite 104Glen Burnie, MD 21061-4058 · (410) 768-2231 · Fax (410) 760-4522
Phone(410) 768-2231
Fax(410) 760-4522
Organization SubpartNo
Authorized OfficialAlice Patricia TannerPediatrician/practice Owner · (410) 768-2231
Enumeration DateMay 8, 2008
✔ NPI 1013184159 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyPediatrics · Adolescent MedicineAllopathic & Osteopathic Physicians
Taxonomy Code2080A0000X
Definition
A pediatrician who specializes in adolescent medicine is a multi-disciplinary healthcare specialist trained in the unique physical, psychological and social characteristics of adolescents, their healthcare problems and needs.
1406 CRAIN HWY S, Glen Burnie, MD 21061
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Other Identifiers 1

Medicaid215896500MD

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 21D0927258

Alice Tanner MD PC · Glen Burnie, MD
Active · expires Apr 13, 2027
CLIA Number21D0927258
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorAlice Tanner
Laboratory Phone(410) 768-2231
Laboratory LocationAlice Tanner MD PC1404 South Crain Highway Suite 109, Glen Burnie, MD 21061
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MRS. KAREN ANN RHODES CSC-AD
Counselor (Addiction (Substance Use Disorder))
1406 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (410) 766-6624
MARY CATHERINE SYLVIA STILES
Counselor (Mental Health)
1406 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (410) 766-6624
DR. ALVIN SERRANO MADARANG M.D.
Internal Medicine
1406 CRAIN HWY S, SUITE 201
GLEN BURNIE, MD 21061
Anne Arundel County (410) 590-4141
NAHVOMA FONBISA
Registered Nurse (Psychiatric/Mental Health, Adult)
1406 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (240) 481-8451
ATLAS PHYSICAL THERAPY & ASSOCIATES, LLC
Clinic/Center (Physical Therapy)
1406 CRAIN HWY S, SUITE 110
GLEN BURNIE, MD 21061
Anne Arundel County (410) 762-2124
ZACHARY CONROY DPT
Physical Therapist
1406 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (410) 762-2124
CLARENDON ENTERPRISE LLC
Dentist (Pediatric Dentistry)
1406 CRAIN HWY S
GLEN BURNIE, MD 21061
Anne Arundel County (240) 247-0388
LAURA M SANNER PT
Physical Therapist
1406 CRAIN HWY S, SUITE #110
GLEN BURNIE, MD 21061
Anne Arundel County (410) 762-2124

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Alice Tanner M.D.,pc's NPI number?

The NPI number for Alice Tanner M.D.,pc is 1013184159. It was assigned to this organization in the NPPES registry on May 8, 2008.

Where is Alice Tanner M.D.,pc located?

Alice Tanner M.D.,pc is located at 1406 Crain Hwy S Suite 104, Glen Burnie, MD 21061. The listed phone number is (410) 768-2231.

What is Alice Tanner M.D.,pc's specialty?

The primary specialty registered for this NPI is Pediatrics, specializing in Adolescent Medicine, with taxonomy code 2080A0000X.

Does Alice Tanner M.D.,pc hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 21D0927258) is associated with this NPI, valid through April 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

When was this NPI record last updated?

The NPPES record for Alice Tanner M.D.,pc was last updated on May 8, 2008. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 18 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.