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

Tanner Souza, DO

Individual provider General Practice Physician · NPI 1447837166

Tanner Souza, DO is an Osteopathic Manipulative Medicine in Coeur D Alene, Idaho. Graduated from Touro Un Col of Osteopathic Medicine, Henderson in 2021, 5 years ago. Practices with Praxis Health PC, a 176-clinician group, works from 2 locations and accepts Medicare assignment. Licensed in Idaho and Nevada.

Years since qualifying
5
Trained at
Touro Un Col of Osteopathic Medicine, Henderson
Licensed in
ID, NV
In the registry since
2021
Specialties on file
2
What do these letters mean?
DO — Doctor of Osteopathic Medicine
A fully licensed physician, trained like an MD with additional musculoskeletal training. Equivalent practice rights in all 50 states.

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Practice location Address checks out

1130 W Prairie Ave
Coeur D Alene, ID 83815-8780
Phone: (208) 209-0288
Fax: (208) 209-0289
Show map & directions

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

Additional practice locations (1)

  • 6655 S Cimarron Rd Ste 100, Las Vegas, NV 89113-2181 — (702) 853-3561

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 0-1993 (ID)
General Practice Physician Taxonomy 208D00000X · Licence DO3477 (NV)

Record details

NPI number1447837166
Entity typeIndividual (Type 1)
GenderMale
Credentials DO
Sole proprietorNo
NPI enumeratedMarch 27, 2021
Last updated in NPPESAugust 23, 2024
Certification dateAugust 23, 2024
Mailing addressPo Box 1517, Pendleton, OR 97801-0410

Medicare enrollment

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

Medicare specialtyOSTEOPATHIC MANIPULATIVE MEDICINE
Also practisesFAMILY PRACTICE
Medical schoolTOURO UN COL OF OSTEOPATHIC MEDICINE, HENDERSON
Graduated 2021 (5 years in practice)
Group practice Praxis Health Pc — 176 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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