Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Mr. Tanner Lee Frey, PHYSICIANASSISTANT

Individual provider Emergency Medical Services (Emergency Medicine) Physician · NPI 1164909479

Mr. Tanner Lee Frey, PHYSICIANASSISTANT is a Physician Assistant in Provo, Utah. Qualified in 2018, 8 years ago. Practices with Exceptional Physician Group Arizona, PLLC, a 12-clinician group and accepts Medicare assignment. Licensed in Utah.

Years since qualifying
8
Licensed in
UT
In the registry since
2018
Specialties on file
2

Practice location Address checks out

1034 N 500 W
Provo, UT 84604-3380
Phone: (801) 358-1076
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Physician Assistant (primary) Taxonomy 363A00000X · Licence 10931513-1206 (UT)
Emergency Medical Services (Emergency Medicine) Physician Taxonomy 207PE0004X · Licence 1153249 (UT)

Record details

NPI number1164909479
Entity typeIndividual (Type 1)
GenderMale
Credentials PHYSICIANASSISTANT
Sole proprietorNo
NPI enumeratedJuly 19, 2018
Last updated in NPPESJuly 13, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyPHYSICIAN ASSISTANT
Medical schoolOTHER
Graduated 2018 (8 years in practice)
Group practice Exceptional Physician Group Arizona, Pllc — 12 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Provo