Individual provider Active NPI

Tammi Ardecki

  • Intellectual & Developmental Disabilities Psychologist
  • Camden, DE
National Provider Identifier
1861099004
Registry record updated Oct 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Intellectual & Developmental Disabilities PsychologistTaxonomy code 103TM1800X
Practice address
227 Wynsome Blvd
Camden, DE 19934-5331
Phone
(302) 573-1231
NPI assigned
Oct 1, 2020
Last updated
Oct 1, 2020By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Intellectual & Developmental Disabilities Psychologist 103TM1800X DE Primary

Addresses

Primary practice location

227 Wynsome Blvd
Camden, DE 19934-5331

Mailing address

227 Wynsome Blvd
Camden, DE 19934-5331

Other identifiers 1

IdentifierTypeStateIssuer
250546371MedicaidDE

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": "1601510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1601510400000",
    "number": "1861099004",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 WYNSOME BLVD",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199345331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 WYNSOME BLVD",
            "city": "CAMDEN",
            "state": "DE",
            "postal_code": "199345331",
            "telephone_number": "302-573-1231"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ARDECKI",
        "first_name": "TAMMI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-10-01",
        "last_updated": "2020-10-01",
        "certification_date": "2020-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "DE",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "250546371",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Camden, DE

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2020; 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.