1780135608 NPI number — MS. EMELINE EVERITT ORWIG LSCSW

Table of content: SUPHICHAYA MUANGMAN M.D. (NPI 1245398619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1780135608 NPI number — MS. EMELINE EVERITT ORWIG LSCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
ORWIG
Provider First Name:
EMELINE
Provider Middle Name:
EVERITT
Provider Name Prefix Text:
MS.
Provider Name Suffix Text:
Provider Credential Text:
LSCSW
Provider Gender Code:
F

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:
1780135608
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
04/02/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
237 26TH ST
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
OGDEN
Provider Business Mailing Address State Name:
UT
Provider Business Mailing Address Postal Code:
84401-3105
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
801-625-3700
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
2001 CLAFLIN RD
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
MANHATTAN
Provider Business Practice Location Address State Name:
KS
Provider Business Practice Location Address Postal Code:
66502-3415
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
785-587-4300
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
10/14/2016

Additional Information

			
		

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  06755 , registered in the state of KS ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .
  • Taxonomy code: 1041C0700X , with the licence number: 9899455-3502 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .

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

  • Identifier: 876000308007 , issued by the state of ( UT ) . This identifiers is of the category "MEDICAID".
  • Identifier: 260022408 . This is a "RAILROAD MEDICARE" identifier , issued by the state of ( UT ) . This identifiers is of the category "OTHER".