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Recently Updated NPI Information — some details in this NPI profile have been updated in the NPI registry within the last 60 days.

TANNER DAVIS DNP
NPI 1962201491
Nurse Practitioner - Family in Dewey, AZ

Active since March 08, 2025PECOS Enrolled
12075 E STATE ROUTE 69 STE B, DEWEY, AZ 86327(928) 772-1673(928) 772-1674 Get Directions Write a Review

NPPES record last updated: July 21, 2026. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Jul 21, 2026, Mar 8, 2025 (2 updates tracked since 2025).

About Tanner Davis Dnp NPPES

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

TANNER DAVIS DNP (NPI 1962201491) is an individual family provider in Dewey, Arizona, licensed in Arizona (341074) and active in the NPI registry since March 2025. He is enrolled in Medicare PECOS, maintains 2 additional practice locations, and is a graduate of Other (2024).

NPPES Registry Identity

NPI1962201491
Entity TypeIndividualMale
Primary Taxonomy363LF0000X
Provider Legal NameTANNER DAVISCredential: DNP
Location Address12075 E STATE ROUTE 69 STE BDewey, AZ 86327-4569
Mailing Address12075 E State Route 69 Ste BDewey, AZ 86327-4569 · (928) 772-1673 · Fax (928) 772-1674
Phone(928) 772-1673
Fax(928) 772-1674
Sole ProprietorNo
Medical School CMSOtherGraduated 2024
Enumeration DateMarch 8, 2025
Last NPPES UpdateJuly 21, 20262 updates tracked since enumeration
NPPES CertifiedJuly 21, 2026
✔ NPI 1962201491 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · FamilyPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LF0000X
License✔ Licensed in AZ · 341074
12075 E STATE ROUTE 69 STE B, Dewey, AZ 86327
Open in Google Maps ↗

Secondary Practice Locations 2

Location 13251 N Windsong DrPrescott Valley, AZ 86314-1222 · Phone (928) 772-2582 · Fax (877) 219-1729
Location 28101 Clayton RdClayton, MO 63117-1103 · Phone (314) 726-2124

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

Tanner Davis Dnp 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 ID7113441320
PECOS Enrollment IDI20250409002553
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 86327 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
$85.89 typical visit price
range $55.44 – $168.60
Typical copayment $21.47 (range $13.86 – $42.15)
Most-billed visit code 99203
Established Patient
$98.00 typical visit price
range $17.72 – $137.41
Typical copayment $24.50 (range $4.43 – $34.35)
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.

Other Providers at the Same Location NPPES 7

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

MS. LINDA JO NELSON FNP
Nurse Practitioner (Family)
12075 E STATE ROUTE 69 STE B
PRESCOTT VALLEY, AZ 86327
Yavapai County (928) 772-1673
TATYANA ERDMANN P.A.
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
LINDSEY M ROBBINS FNP-C
Nurse Practitioner (Family)
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
MIRYAM ROSE KNIGGE PA
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
AUSTIN JOHN HARMON PA-C
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
ALYSSA WAHLSTROM PA-C
Physician Assistant
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (928) 772-1673
ASURA HEALTHCARE LLC
Family Medicine
12075 E STATE ROUTE 69 STE B
DEWEY, AZ 86327
Yavapai County (405) 590-8861

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 Davis's NPI number?

The NPI number for Tanner Davis is 1962201491. It was assigned to this individual provider in the NPPES registry on March 8, 2025.

Where is Tanner Davis located?

Tanner Davis practices at 12075 E State Route 69 Ste B, Dewey, AZ 86327. The listed phone number is (928) 772-1673.

What is Tanner Davis's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.

Is Tanner Davis enrolled in Medicare?

Yes. Tanner Davis 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 Tanner Davis was last updated on July 21, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 days 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.