Active NPI
Linda Brumback
- School Psychologist
- Red Bud, IL
National Provider Identifier
1841704475
On this page
Key facts
NPPES NPI Registry- Primary specialty
- School Psychologist
- License
- 00616403
- Practice address
- 1525 Locust St
Red Bud, IL 62278-1374 - Phone
- (618) 282-6251
- NPI assigned
- Nov 17, 2017
- Last updated
- Nov 17, 2017
- 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 Psychologist | 103TS0200X | 00616403 | NU | Primary |
Addresses
Primary practice location
1525 Locust St
Red Bud, IL 62278-1374
Mailing address
1525 Locust St
Red Bud, IL 62278-1374
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 00616403 | Medicaid | IL |
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Perandoe Special Education District | 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Local Education Agency (LEA)
- Red Bud, IL
- NPI 1871792648
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1510876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1510876800000",
"number": "1841704475",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1525 LOCUST ST",
"city": "RED BUD",
"state": "IL",
"postal_code": "622781374"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1525 LOCUST ST",
"city": "RED BUD",
"state": "IL",
"postal_code": "622781374",
"telephone_number": "618-282-6251"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BRUMBACK",
"first_name": "LINDA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-11-17",
"last_updated": "2017-11-17",
"status": "A"
},
"taxonomies": [
{
"code": "103TS0200X",
"taxonomy_group": "",
"desc": "Psychologist, School",
"state": "NU",
"license": "00616403",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "00616403",
"state": "IL"
}
],
"endpoints": [],
"other_names": []
}Other providers in Red Bud, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 17, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.