Delane Tidzump

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

#7 Shipton Lane
Fort Washakie, WY 82514-0538

Phone

(307) 335-1169

Fax

(307) 335-1170

NPI assigned

Jun 1, 2016

Last updated

Jun 1, 2016By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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

• Doya Natsu Healing Center- Eastern Shoshone Tribe

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Fort Washakie, WY
  • NPI 1265751309
  NPD (past)

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1464739200000",
    "number": "1568810315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 538",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140538",
            "telephone_number": "307-335-1169",
            "fax_number": "307-335-1170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "#7 SHIPTON LANE",
            "city": "FORT WASHAKIE",
            "state": "WY",
            "postal_code": "825140538",
            "telephone_number": "307-335-1169",
            "fax_number": "307-335-1170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIDZUMP",
        "first_name": "DELANE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2016-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Courtnie Stringham, RT (R)
• Luke Stringham, RPH
• Percille Leta Sun Rhodes
• Marsha Taggart, RN MPH
• David Thatch, MT
• US Health Dept of Health & Human Services
• Marion Gean Ute, RN
• Bradley W Vincent
• Debra Kay Waters, MLT
• Kellie Rene Webb, LAT

• Case Manager/Care Coordinator in Fort Washakie, WY
• Providers in Fort Washakie, WY by specialty
• Case Manager/Care Coordinator in Wyoming

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2016; 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.