Tanager Place

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

TANAGER PLACE

Practice address

2309 C St SW
Cedar Rapids, IA 52404-3707

Phone

(319) 365-9164

Fax

(319) 365-6411

NPI assigned

Jan 26, 2007

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Mr. Jeff Humiston

Title

C.F.O.

Phone

(319) 365-9165

Specialties & licenses 1

Addresses

Other identifiers 2

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1169769600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1053467423",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2309 C ST SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043707",
            "telephone_number": "319-365-9164",
            "fax_number": "319-365-6411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2309 C ST SW",
            "city": "CEDAR RAPIDS",
            "state": "IA",
            "postal_code": "524043707",
            "telephone_number": "319-365-9164",
            "fax_number": "319-365-6411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TANAGER PLACE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-01-26",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "HUMISTON",
        "authorized_official_first_name": "JEFF",
        "authorized_official_title_or_position": "C.F.O.",
        "authorized_official_telephone_number": "319-365-9165",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK PROVIDER #",
            "identifier": "38468",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0427054",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Michelle M. Takes, LMHC
• Breanna Marie Garcia Talbert, AGNP
• Tallgrass ABA Therapy LLC
• Benjamin Ashley Tallman, PHD
• Tanager Place
• Tanager Place (Tanager Place PMIC)
• Tanager Place
• Tanager Place (Tanager Place ICFMR)
• Michele Tangeman
• Kevin Scott Tanner, D.P.M.

• Community/Behavioral Health Agency in Cedar Rapids, IA
• Providers in Cedar Rapids, IA by specialty
• Community/Behavioral Health Agency in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 22, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.