Ida Mary Umentum, MSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

888-122 Issued in WI

Practice address

141 Siegler St
Green Bay, WI 54303-2635

Phone

(920) 497-3126

NPI assigned

May 30, 2007

Last updated

Jul 8, 2007By 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 1

Addresses

Other names 1

• Ida Mary Schanen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1180483200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1811198799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3122 SAVANNA WAY",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543115043",
            "telephone_number": "920-321-0387"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 SIEGLER ST",
            "city": "GREEN BAY",
            "state": "WI",
            "postal_code": "543032635",
            "telephone_number": "920-497-3126"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "UMENTUM",
        "first_name": "IDA",
        "middle_name": "MARY",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-30",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "WI",
            "license": "888-122",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "IDA",
            "last_name": "SCHANEN",
            "middle_name": "MARY",
            "credential": "MSW",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

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• Social Worker in Green Bay, WI
• Providers in Green Bay, WI by specialty
• Social Worker in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.