Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1790012201 Individual Practitioner Male Practitioner

Dr. Dustin James Tanner , DC

Chiropractor • St Augustine, FL

Professional Overview & Biography Verified Profile Summary

Dr. Dustin Tanner, DC is a registered healthcare professional specializing in Chiropractor in St Augustine, FL. Practice services are available at 2200 N PONCE DE LEON BLVD under active NPI credentials.

Practice Location & Contact Primary Location

Practice Address

2200 N Ponce De Leon Blvd
Suite #1

St Augustine, FL 320842600

Telephone 9048199110
Fax 9048199310
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Chiropractor in St Augustine, FL

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 17.1 Yrs
State Avg: 21.7 Yrs
Regional Practice Density
33 Specialists

Practicing in St Augustine, FL (7309 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Chiropractor Primary Specialty

NUCC Taxonomy Code: 111N00000X

State License FL CH 10578

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.

Chiropractor

NUCC Taxonomy Code: 111N00000X

State License NY X012022-1

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.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

6 Associated Practitioners
NPI 1154587624

Licensed Massage Therapist

Lorelei Walker , LMT

Massage Therapist

NPI 1467744060

Licensed Massage Therapist

Amy Mcdermott , LMHC

Counselor - Mental Health

NPI 1497734867

Licensed Mental Health Counselor

Paula Sullivan , LCSW

Social Worker - Clinical

NPI 1538121488

Licensed Clinical Social Worker

Nicolle Bauer , LMHC

Counselor - Mental Health

NPI 1588642987

Licensed Mental Health Counselor

Christopher Misso , LMT

Massage Therapist

NPI 1780923623

Licensed Massage Therapist

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

6 Historical Events
NPI Profile Active May 29, 2012

NPI status registered as active in NPPES database

📍
Updated Practice Location May 29, 2012

Registered at 2200 N PONCE DE LEON BLVD, SUITE #1, ST AUGUSTINE, FL 320842600 (Tel: 9048199110)

📍
Updated Business Mailing Address May 29, 2012

Registered at 2200 N PONCE DE LEON BLVD, SUITE #1, ST AUGUSTINE, FL 320842600 (Tel: 3152244042)

👤
Provider Name / Credentials Updated May 29, 2012

Recorded as DUSTIN TANNER, D.C.

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 29, 2012

Chiropractor (License #CH 10578 in FL)

🟢
Initial NPI Registration & Enumeration November 05, 2009

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1790012201
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 05, 2009
Last Update: May 29, 2012
Sole Proprietor: No

Mailing Address

2200 N Ponce De Leon Blvd, Suite #1

St Augustine, FL 320842600

Phone: 3152244042

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.