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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 30 days.

JORDAN TANNER 95091873 RN
NPI 1265255475
Nurse Practitioner - Psychiatric/Mental Health in Ione, CA

Active since November 05, 2024PECOS EnrolledAccepts Medicare Assignment
1013 FAIRWAY DR, IONE, CA 95640(925) 732-1901 Get Directions Write a Review

NPPES record last updated: July 2, 2026. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Jan 8, 2026, Feb 4, 2025, Nov 5, 2024 (3 updates tracked since 2024).

About Jordan Tanner 95091873 Rn NPPES

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

JORDAN TANNER 95091873 RN (NPI 1265255475) is an individual psychiatric/mental health provider in Ione, California, licensed in California (95036141) and active in the NPI registry since November 2024. He is enrolled in Medicare PECOS and is a graduate of Other (2025).

NPPES Registry Identity

NPI1265255475
Entity TypeIndividualMale
Primary Taxonomy363LP0808X
Provider Legal NameJORDAN TANNERCredential: 95091873 RN
Location Address1013 FAIRWAY DRIone, CA 95640-5400
Mailing Address1013 Fairway DrIone, CA 95640-5400 · (925) 723-1901
Phone(925) 732-1901
Sole ProprietorNo
Medical School CMSOtherGraduated 2025
Enumeration DateNovember 5, 2024
Last NPPES UpdateJuly 2, 20263 updates tracked since enumeration
NPPES CertifiedJuly 2, 2026
✔ NPI 1265255475 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Psychiatric/Mental HealthPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP0808X
License✔ Licensed in CA · 95036141
1013 FAIRWAY DR, Ione, CA 95640
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Jordan Tanner 95091873 Rn is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID7911489208
PECOS Enrollment IDI20260305001776
Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 95640 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient
$90.32 typical visit price
range $58.87 – $176.60
Typical copayment $22.58 (range $14.71 – $44.15)
Most-billed visit code 99203
Established Patient
$103.36 typical visit price
range $19.28 – $144.60
Typical copayment $25.84 (range $4.82 – $36.15)
Most-billed visit code 99214
Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

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 Jordan Tanner's NPI number?

The NPI number for Jordan Tanner is 1265255475. It was assigned to this individual provider in the NPPES registry on November 5, 2024.

Where is Jordan Tanner located?

Jordan Tanner practices at 1013 Fairway Dr, Ione, CA 95640. The listed phone number is (925) 732-1901.

What is Jordan Tanner's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Psychiatric/Mental Health, with taxonomy code 363LP0808X.

Is Jordan Tanner enrolled in Medicare?

Yes. Jordan Tanner is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

When was this NPI record last updated?

The NPPES record for Jordan Tanner was last updated on July 2, 2026. NPI Profile syncs with the weekly NPPES data releases published by CMS.