Active NPI
Robert Neil Tangen, LMSW
- Social Worker
- Boise, ID
National Provider Identifier
1336571694
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- LMSW-27787
- Practice address
- 1276 W River St
Suite 100
Boise, ID 83702-7066 - Phone
- (208) 338-4699
- Fax
- (208) 322-4711
- NPI assigned
- Aug 8, 2013
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | LMSW-27787 | ID | Primary |
Addresses
Primary practice location
1276 W River St
Suite 100
Boise, ID 83702-7066
Mailing address
1276 W River St
Suite 100
Boise, ID 83702-7066
Phone (208) 338-4699
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| LMSW-27787 | ID | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1375920000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1375920000000",
"number": "1336571694",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1276 W RIVER ST",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837027066",
"telephone_number": "208-338-4699",
"fax_number": "208-322-4711"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1276 W RIVER ST",
"address_2": "SUITE 100",
"city": "BOISE",
"state": "ID",
"postal_code": "837027066",
"telephone_number": "208-338-4699",
"fax_number": "208-322-4711"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TANGEN",
"first_name": "ROBERT",
"middle_name": "NEIL",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2013-08-08",
"last_updated": "2013-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "ID",
"license": "LMSW-27787",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Boise, ID
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.