1306204805 NPI number — SENTIENT PHYSICIANS, P.C.

Table of content: DR. AMANDA BREE SALTER MD (NPI 1255644902)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306204805 NPI number — SENTIENT PHYSICIANS, P.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
SENTIENT PHYSICIANS, P.C.
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1306204805
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
07/05/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
3 MARYLAND FARMS STE 200
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BRENTWOOD
Provider Business Mailing Address State Name:
TN
Provider Business Mailing Address Postal Code:
37027-5005
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
800-348-4565
Provider Business Mailing Address Fax Number:
888-203-4247

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
3 MARYLAND FARMS STE 200
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BRENTWOOD
Provider Business Practice Location Address State Name:
TN
Provider Business Practice Location Address Postal Code:
37027
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
800-348-4565
Provider Business Practice Location Address Fax Number:
888-203-4247
Provider Enumeration Date:
01/29/2016

Additional Information

Authorized Official

Authorized Official Last Name:
COHEN
Authorized Official First Name:
JEFFREY
Authorized Official Middle Name:
Authorized Official Title or Position:
NATIONAL MEDICAL DIRECTOR
Authorized Official Telephone Number:
800-348-4565

Provider Taxonomy Codes

  • Taxonomy code: 2084N0400X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 024821700 . This is a "Florida Medicaid Provider ID" identifier , issued by the state of ( FL ) . This identifiers is of the category "MEDICAID".




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