Individual provider Active NPI

Tiernan McIlwaine, MSW

  • Case Manager/Care Coordinator
  • Cheyenne, WY
National Provider Identifier
1265701759
Registry record updated Apr 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
821 W Pershing Blvd
Cheyenne, WY 82001-2537
Phone
(307) 421-9329
NPI assigned
Dec 29, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 27, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X LCSW-1666 WY
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

821 W Pershing Blvd
Cheyenne, WY 82001-2537

Mailing address

3719 Dover Rd
Cheyenne, WY 82001-1606
Phone (307) 632-8911

Other practice location 1

3719 Dover Rd
Cheyenne, WY 82001-1606
Phone (307) 632-8911

Electronic endpoints 1

TypeEndpointUseAffiliation
FHIR URL BestNotes Health Information Exchange (HIE)

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

State licenses

LicenseStateTypeSpecialty
LCSW-1666WYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Liane P McIlwaine 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": "1325116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1714176000000",
    "number": "1265701759",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3719 DOVER RD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820011606",
            "telephone_number": "307-632-8911",
            "fax_number": "307-433-0487"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "821 W PERSHING BLVD",
            "city": "CHEYENNE",
            "state": "WY",
            "postal_code": "820012537",
            "telephone_number": "307-421-9329"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3719 Dover Rd",
            "address_purpose": "LOCATION",
            "city": "Cheyenne",
            "state": "WY",
            "postal_code": "820011606",
            "country_code": "US",
            "telephone_number": "307-632-8911",
            "fax_number": "307-433-0487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MCILWAINE",
        "first_name": "TIERNAN",
        "name_prefix": "Mr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-12-29",
        "last_updated": "2024-04-27",
        "certification_date": "2021-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "LCSW-1666",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "BestNotes",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "EHR",
            "address_1": "821 W Pershing Blvd",
            "city": "Cheyenne",
            "state": "WY",
            "country_code": "US",
            "postal_code": "820012537",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Cheyenne, WY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2024; 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.