Taxonomy Codes
The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:
| No. |
Taxonomy Code |
Taxonomy Clasification |
Taxonomy Specialization |
License Number |
License State |
Primary |
| 1 | 174400000X | Specialist | | 45893 | TENNESSEE | No |
| 2 | 2084N0400X | Psychiatry & Neurology | Neurology | | | No |
| 3 | 2084P2900X | Psychiatry & Neurology | Pain Medicine | | | No |
| 4 | 208VP0000X | Pain Medicine | Pain Medicine | | | Yes |
Other Identifiers
The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.
| No. |
Other Provider Identifier |
Other Provider Identifier Type |
Other Provider Identifier State |
Other Provider Identifier Issuer |
| 1 | 19321240951 | OTHER | | INDIVIDUAL NPI - JOHANNA JIRIKOVEC, NP |
| 2 | 1730145285 | OTHER | | INDIVIDUAL NPI - JOHN SCHNEIDER, MD |
| 3 | 1013245588 | OTHER | | INDIVIDUAL NPI - MISTIE GERMEK, PHD |
| 4 | 1525675 | MEDICAID | TENNESSEE | |
| 5 | 10370G1506 | OTHER | | GROUP MEDICARE PTAN NUMBER |
| 6 | 1619217106 | OTHER | | INDIVIDUAL NPI - MEGAN CHILDERS, NP |
| 7 | 1538414305 | OTHER | | INDIVIDUAL NPI - MONICA SATTERWHITE, NP |
| 8 | 44D2099106 | OTHER | | CLIA WAIVER # |
| 9 | 1104365964 | OTHER | | INDIVIDUAL NPI - AMANDA MASON, NP |
| 10 | 1215273917 | OTHER | | INDIVIDUAL NPI - DANA CARTER, NP |
| 11 | 1588944532 | OTHER | | GROUP NPI NUMBER |