Amy White Diller
Individual provider Active NPI Clinical Social Worker · Murfreesboro, TN
NPI 1477929917 · NPPES record last updated May 3, 2017
Key facts
- NPI
- 1477929917
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Clinical Social Worker 1041C0700X
- License
- 4362 (TN)
- Practice address
- 1630 S Church St
Ste 104
Murfreesboro, TN 37130-5551 - Phone
- (615) 295-2176
- Fax
- (615) 295-2645
- NPI assigned
- Aug 19, 2015
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 3
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- University of North Carolina at Chapel Hill School of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Omni Community Health, Inc.
Practice addresses (Care Compare)
545 Brandies Cir
Murfreesboro, TN 37128-7687
Phone (615) 295-2176
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in TN
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20170215002382 | TN | Practitioner - Clinical Social Worker | 9234423492 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4362 | TN | MD | Physician Assistant |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Omni Community Health, Inc. | Clinical | Current |
Accepting new patients |
| The Solution Source, LLC. | Past | Accepting new patients | |
| Omni Community Health | Past | Accepting new patients |
Locations
1401 Williams St
Ste 210
Chattanooga, TN 37408
Phone (423) 207-4712
2600 Executive Park NW
Cleveland, TN 37312
Phone (423) 458-4122
1365 Maley Hollow Rd
Dayton, TN 37321
Phone (314) 503-7015
4709 Papermill Dr
Ste 100
Knoxville, TN 37909
103 Weakley Creek Rd
#B
Lawrenceburg, TN 38464
Phone (931) 766-1916
545 Brandies Cir
Murfreesboro, TN 37128
Phone (615) 295-2176
301 S Perimeter Park Dr
Ste 210
Nashville, TN 37211
Phone (615) 726-3603
145 Thompson Ln
Nashville, TN 37211
Phone (615) 781-0013
22510 Alberta St
Oneida, TN 37841
Phone (423) 215-9555
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 4362 | TN | Yes |
Addresses
Primary practice location
1630 S Church St
Ste 104
Murfreesboro, TN 37130-5551
Mailing address
301 S Perimeter Park Dr
Suite 210
Nashville, TN 37211-4143
Phone (615) 295-2176
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1534575 | Medicaid | TN |
Other names
- Amy White
Other providers in Murfreesboro, TN
- Annola Kilai Dildy
- Jessica Dileo
- Colette Melanie Dill
- Kevin Key Dillard
- Jillian Rose Dillehay
- Lara Christine Dillihay
- Alizabeth Dillman
- Caitlyn Dillon
- Evan Leland Dillon
- Abigail Leigh Dinkelacker
All providers in Murfreesboro, TN · Clinical Social Worker in Tennessee
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on May 3, 2017. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.