DR. TAMMY ANNE MARTIELLI (NPI# 1104013689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104013689 |
| Entity Type | Individual |
| Full Name | DR. TAMMY ANNE MARTIELLI |
| Other Name | MISS TAMMY ANNE MANDERNACH |
| Credential | PH.D. |
| Practice Address |
425 N New Ballas Rd Ste 290 Creve Coeur MO 63141-6852 |
| Practice Telephone | 3143243800 |
| Practice Fax Number | 3142607676 |
| Mailing Telephone | 3143243800 |
| Mailing Fax Number | 3142607676 |
| Enumeration Date | 2007-09-28 |
| Last Update Date | 2020-06-30 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103G00000X | Clinical Neuropsychologist | 2009010486 | MO | Behavioral Health & Social Service Providers |
| N | 103TC0700X |
Psychologist Specialization: Clinical |
2009010486 | MO | Behavioral Health & Social Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4542 W Pine Blvd, Saint Louis, MO 631082186 | 3143243800 | 3142607676 |
| Street Address |
425 N NEW BALLAS RD STE 290 |
| City | CREVE COEUR |
| State | MO |
| Zip Code | 63141-6852 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679102842 | Noor Ramadan | Pharmacist | 628 North New Ballad Road, Suite A, Creve Coeur, MO 63141 | 2020-04-08 |
| 1497381206 | Washington University | Durable Medical Equipment & Medical Supplies | 1044 North Mason Road, Suite 110/210, St. Louis, MO 63141 | 2020-03-13 |
| 1154956498 | Ashleigh Clendenny | Physician Assistant | Mercy Hospital St. Louis, 615 S New Ballas Rd, St. Louis, MO 63141 | 2020-03-06 |
| 1801429410 | Emili Lou Haley | Registered Nurse | 650 Maryville Drive, St Louis, MO 63141 | 2020-02-21 |
| 1629553110 | Rebecca Kathleen Pike | Social Worker | West County Psychological Associates, 12125 Woodcrest Executive Drive #110, St. Louis, MO 63141 | 2018-10-01 |
| 1649756099 | River City Sedation Associates, LLC | Nurse Anesthetist, Certified Registered | 12855 N 40 Dr Ste 150, Saint Louis, MO 63141 | 2018-07-18 |
| 1205333952 | Ear Care and Hearing of St. Louis | Hearing Aid Equipment | 11630 Studt Ave Ste 210, Creve Coeur, MO 63141 | 2018-04-10 |
| 1659897486 | Erin Goodman | Physical Therapist | 10560 Old Olive St. Rd, Suite 100, Creve Coeur, MO 63141 | 2017-08-14 |
| 1093230450 | Center for Urologic Surgery LLC | Clinic/Center | 12855 N 40 Dr Ste 100, Saint Louis, MO 63141 | 2017-08-07 |
| 1871016105 | Jacob Farley Tanner | Specialist/Technologist | 1054 Town and Four Parkway Dr, Creve Coeur, MO 63141 | 2017-07-19 |
| Find all providers in zip 63141 | ||||
| Taxonomy Code | 103G00000X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Clinical Neuropsychologist |
| An individual with a doctorate degree, licensure in clinical psychology and specialized training or board certification in neuropsychology who practices or adheres to the principles of neuropsychology; a specialty within the field of psychology focusing primarily on neurobehavioral functioning. |
| Notes: Source: American Psychological Association, Washington, DC, 1997. [1/1/2007: title modified] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1780127449 | Gateway Neuropsychology, LLC | Clinical Neuropsychologist | 989 Gardenview Office Pkwy, Creve Coeur, MO 63141-5917 | 2016-11-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144873159 | Stephanie Ross Potts | Clinical Neuropsychologist | 1027 Bellevue Ave Ste 142, Saint Louis, MO 63117-1851 | 2019-07-18 |
| 1508259003 | Maria Catherine Rothhaar | Clinical Neuropsychologist | 522 N New Ballas Rd Ste 121, Saint Louis, MO 63141-6820 | 2015-03-09 |
| 1578909925 | Sharon Brooks | Clinical Neuropsychologist | 2209 Potomac Dr, Columbia, MO 65203-5886 | 2013-05-13 |
| 1306190913 | Robert L Coffman | Clinical Neuropsychologist | 1245 N Butterfield Rd Ste C1, Bolivar, MO 65613-3017 | 2012-11-05 |
| 1366790941 | Pediatric Neuropsychological Services, LLC | Clinical Neuropsychologist | 175 S. Marshall, Suite G, Rogersville, MO 65742 | 2012-08-29 |
| 1750612925 | Stress Control Center Inc, P C | Clinical Neuropsychologist | 800 W 47th St Ste 514, Kansas City, MO 64112-1247 | 2010-01-27 |
| 1366694937 | Dawn Heather Huber | Clinical Neuropsychologist | 175 S Marshall St, Suite G, Rogersville, MO 65742-8828 | 2008-10-15 |
| 1689852253 | Stacey Woodrome | Clinical Neuropsychologist | 3800 Park Ave Fl 2, Saint Louis, MO 63110-2514 | 2008-02-06 |
| 1659551406 | Wright & Wright, Phd, LLC | Clinical Neuropsychologist | 16141 Swingley Ridge Rd, Suite 106, Chesterfield, MO 63017-1774 | 2007-11-09 |
| 1144411513 | Maureen O'kane Grissom | Clinical Neuropsychologist | Thompson Center, 300 Portland St., Suite, 110, Columbia, MO 65211-0001 | 2007-08-09 |
| Find all providers with the same taxonomy | ||||
| City | CREVE COEUR |
| Zip Code | 63141 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.