Individual provider Active NPI

Tammy Smedema, RTR

  • Computed Tomography Radiologic Technologist
  • Milwaukee, WI
National Provider Identifier
1679767560
Registry record updated Sep 4, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Computed Tomography Radiologic TechnologistTaxonomy code 2471C3401X
License
256392 Issued in WI
Practice address
2626 N 76TH St
105
Milwaukee, WI 53213-1137
Phone
(414) 771-9171
NPI assigned
Sep 4, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Computed Tomography Radiologic Technologist 2471C3401X 256392 WI Primary

Addresses

Primary practice location

2626 N 76TH St
105
Milwaukee, WI 53213-1137

Mailing address

2626 N 76TH St
105
Milwaukee, WI 53213-1137
Phone (414) 771-9171

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
256392WIMDComputed Tomography Radiologic Technologist

Practice roles

OrganizationSpecialtyStatusNew patients
Affiliated Health of Wisconsin LTD. Computed Tomography 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": "1188864000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1188864000000",
    "number": "1679767560",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2626 N 76TH ST",
            "address_2": "105",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532131137",
            "telephone_number": "414-771-9171"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2626 N 76TH ST",
            "address_2": "105",
            "city": "MILWAUKEE",
            "state": "WI",
            "postal_code": "532131137",
            "telephone_number": "414-771-9171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SMEDEMA",
        "first_name": "TAMMY",
        "credential": "RTR",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-04",
        "last_updated": "2007-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2471C3401X",
            "taxonomy_group": "",
            "desc": "Radiologic Technologist, Computed Tomography",
            "state": "WI",
            "license": "256392",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Milwaukee, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 4, 2007; 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.