1093887119 NPI number — MRS. TAMMY LYNN SCHILLING-MONTGOMERY LCMSW MHP

Table of content: MRS. TAMMY LYNN SCHILLING-MONTGOMERY LCMSW MHP (NPI 1093887119)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1093887119 NPI number — MRS. TAMMY LYNN SCHILLING-MONTGOMERY LCMSW MHP

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SCHILLING-MONTGOMERY
Provider First Name:
TAMMY
Provider Middle Name:
LYNN
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCMSW MHP
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:
1093887119
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
2482 200TH ROAD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SABETHA
Provider Business Mailing Address State Name:
KS
Provider Business Mailing Address Postal Code:
66534
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
785-284-0008
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
116 WEST 19TH
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
FALLS CITY
Provider Business Practice Location Address State Name:
NE
Provider Business Practice Location Address Postal Code:
68355
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
402-245-4458
Provider Business Practice Location Address Fax Number:
402-245-4458
Provider Enumeration Date:
11/14/2006

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: 101YM0800X , with the licence number:  1439 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .
  • Taxonomy code: 1041C0700X , with the licence number: 712 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "X" .

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

  • Identifier: 470528515-03 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-04 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-15 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-02 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-14 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 82336 . This is a "BCBS" identifier , issued by the state of ( NE ) . This identifiers is of the category "OTHER".
  • Identifier: 470528515-00 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-05 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-06 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-07 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-01 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-10 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-13 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 8354 . This is a "MIDLANDS CHOICE" identifier . This identifiers is of the category "OTHER".
  • Identifier: 10025208200 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-09 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".
  • Identifier: 470528515-17 , issued by the state of ( NE ) . This identifiers is of the category "MEDICAID".




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