Individual provider Active NPI

Tia Hummel

  • Case Manager/Care Coordinator
  • Portland, OR
National Provider Identifier
1134575715
Registry record updated Dec 5, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
11035 NE Sandy Blvd
Portland, OR 97220-2553
Phone
(503) 258-4200
NPI assigned
May 12, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 5, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Developmental Therapist 222Q00000X
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

11035 NE Sandy Blvd
Portland, OR 97220-2553

Mailing address

11035 NE Sandy Blvd
Portland, OR 97220-2553
Phone (503) 258-4200

Other practice location 1

321 Fortune Blvd
Campus Box 1026
Milford, MA 01757-1750
Phone (508) 478-0207

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Morrison Child and Family Services Past Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1463011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1543968000000",
    "number": "1134575715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11035 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202553",
            "telephone_number": "503-258-4200"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11035 NE SANDY BLVD",
            "city": "PORTLAND",
            "state": "OR",
            "postal_code": "972202553",
            "telephone_number": "503-258-4200"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "321 Fortune Blvd",
            "address_2": "Campus Box 1026",
            "address_purpose": "LOCATION",
            "city": "Milford",
            "state": "MA",
            "postal_code": "017571750",
            "country_code": "US",
            "telephone_number": "508-478-0207",
            "fax_number": "508-634-6989",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "HUMMEL",
        "first_name": "TIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-05-12",
        "last_updated": "2018-12-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "222Q00000X",
            "taxonomy_group": "",
            "desc": "Developmental Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Portland, OR

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2018; 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.