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TANNER CLARK DC
NPI 1215465042
Chiropractor in Bountiful, UT

Active since May 24, 2017
458 N 500 W, BOUNTIFUL, UT 84010(801) 292-9355(801) 296-8050 Get Directions Write a Review

NPPES record last updated: July 21, 2022. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Jul 21, 2022, May 24, 2017 (2 updates tracked since 2017).

About Tanner Clark Dc NPPES

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

TANNER CLARK DC (NPI 1215465042) is an individual chiropractor in Bountiful, Utah, licensed in Utah (10316520-1202) and active in the NPI registry since May 2017.

NPPES Registry Identity

NPI1215465042
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameTANNER CLARKCredential: DC
Location Address458 N 500 WBountiful, UT 84010-6948
Mailing Address458 N 500 WBountiful, UT 84010-6948 · (801) 292-9355 · Fax (801) 296-8050
Phone(801) 292-9355
Fax(801) 296-8050
Sole ProprietorNo
Enumeration DateMay 24, 2017
Last NPPES UpdateJuly 21, 20222 updates tracked since enumeration
✔ NPI 1215465042 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in UT · 10316520-1202
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
458 N 500 W, Bountiful, UT 84010
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and more.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Tanner Clark Dc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Medicare Billing Reassignment

Medicare enrollment records show Tanner Clark reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Apr Medical LLC
335 mi
Chiropractor
1001 W OAK ST, BLDG C STE 210
Bozeman, MT 59715
  • Reassigned Medicare billing, Montana enrollment
  • 4 clinicians in this Medicare group
NPI 1245982685 (406) 587-8446

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 10

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

DR. CORY M FROGLEY D.C.
Chiropractor
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355
JUDD GINES
Chiropractor
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355
MISS LAUREN LIGHTFIELD AGACNP
Nurse Practitioner (Acute Care)
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355
INTEGRATED WELLNESS GROUP LLC
Chiropractor
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355
STEVEN IVAN WHITE PA
Physician Assistant
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355
BRETT EARL MD
General Practice
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 296-8060
TRAVIS ENRIQUE CASTILLON D.C.
Chiropractor
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 296-8060
INTEGRATED FUNCTIONAL MEDICINE
General Practice
458 N 500 W
BOUNTIFUL, UT 84010
Davis County (801) 292-9355

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 Tanner Clark's NPI number?

The NPI number for Tanner Clark is 1215465042. It was assigned to this individual provider in the NPPES registry on May 24, 2017.

Where is Tanner Clark located?

Tanner Clark practices at 458 N 500 W, Bountiful, UT 84010. The listed phone number is (801) 292-9355.

What is Tanner Clark's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Tanner Clark enrolled in Medicare?

Yes. Tanner Clark is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Tanner Clark's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Tanner Clark reassigns Medicare benefits to Apr Medical LLC (Bozeman, MT). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Tanner Clark's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Tanner Clark accept?

Health plans from Blue Cross and Blue Shield of Montana, Mountain Health CO-OP, PacificSource Health Plans and UnitedHealthcare list Tanner Clark as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tanner Clark was last updated on July 21, 2022. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 4 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.