Active NPI
Tiernan McIlwaine, MSW
- Case Manager/Care Coordinator
- Cheyenne, WY
National Provider Identifier
1265701759
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| LCSW-1666 | WY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New 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.
-
- Developmentally Disabled Services Day Training Agency
- Cheyenne, WY
- NPI 1932337714
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.