Active NPI
Tatayana Groom
- School Social Worker
- Chicago, IL
National Provider Identifier
1700460839
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Social Worker
- Practice address
- 5080 N Elston Ave
Chicago, IL 60630-2459 - Phone
- (773) 769-4313
- NPI assigned
- May 5, 2021
- Sex
- Female
- 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 |
|---|---|---|---|---|
| School Social Worker | 1041S0200X | Primary |
Addresses
Primary practice location
5080 N Elston Ave
Chicago, IL 60630-2459
Mailing address
5080 N Elston Ave
Chicago, IL 60630-2459
Phone (773) 769-4313
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | tgroom@envisionunlimited.org |
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1620172800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1620172800000",
"number": "1700460839",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5080 N ELSTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302459",
"telephone_number": "773-769-4313"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5080 N ELSTON AVE",
"city": "CHICAGO",
"state": "IL",
"postal_code": "606302459",
"telephone_number": "773-769-4313"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GROOM",
"first_name": "TATAYANA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-05-05",
"last_updated": "2021-05-05",
"certification_date": "2021-05-05",
"status": "A"
},
"taxonomies": [
{
"code": "1041S0200X",
"taxonomy_group": "",
"desc": "Social Worker, School",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "tgroom@envisionunlimited.org",
"affiliation": "N",
"address_1": "5080 N Elston Ave",
"city": "Chicago",
"state": "IL",
"country_code": "US",
"postal_code": "606302459",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Chicago, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.