Individual provider Active NPI

Aniella Tarantino

  • Social Worker
  • Green Bay, WI
National Provider Identifier
1730906876
Registry record updated Sep 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
135083-121 Issued in WI
Practice address
704 S Webster Ave
Green Bay, WI 54301-3528
Phone
(920) 433-3630
Fax
(920) 437-0533
NPI assigned
Sep 20, 2024
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 20, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 135083-121 WI Primary

Addresses

Primary practice location

704 S Webster Ave
Green Bay, WI 54301-3528

Mailing address

744 S Webster Ave
Medical Staff Services
Green Bay, WI 54301

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
135083-121WIMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1726790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726790400000",
    "number": "1730906876",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "744 S WEBSTER AVE",
            "address_2": "MEDICAL STAFF SERVICES",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "54301",
            "fax_number": "920-433-6090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "704 S WEBSTER AVE",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543013528",
            "telephone_number": "920-433-3630",
            "fax_number": "920-437-0533"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TARANTINO",
        "first_name": "ANIELLA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-09-20",
        "last_updated": "2024-09-20",
        "certification_date": "2024-09-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "135083-121",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Green Bay, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2024; 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.