PHYLLIS HOLT VILTZ (NPI# 1912052689) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
Nation Provider ID (NPI) | 1912052689 |
Entity Type | Individual |
Full Name | PHYLLIS HOLT VILTZ |
Other Name | PHYLLIS EDWINA HOLT |
Credential | SPE |
Practice Address |
620 Gallatin Pike S Madison TN 37115-4013 |
Mailing Address |
1014 Christopher Ln Ashland City TN 37015-2823 |
Practice Telephone | 6154604318 |
Practice Fax Number | 6154604308 |
Mailing Telephone | 6157922836 |
Mailing Fax Number | 6156502929 |
Enumeration Date | 2007-01-24 |
Last Update Date | 2007-07-08 |
Gender Code | F |
Is Sole Proprietor | N |
Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
---|---|---|---|---|---|
Y | 103TB0200X |
Psychologist Specialization: Cognitive & Behavioral |
PE0000011569 | TN | Behavioral Health & Social Service Providers |
Street Address |
620 GALLATIN PIKE S |
City | MADISON |
State | TN |
Zip Code | 37115-4013 |
NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1316926553 | Sue St Clair | Nurse Practitioner | 620 Gallatin Pike S, Suite 214, Madison, TN 37115-4013 | 2006-01-16 |
1356960124 | Victoria Ann Fung-a-fat | Pharmacist | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2020-04-13 |
1962035915 | Olga Olivia Stanfill | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2020-02-18 |
1669010286 | Jennifer Janel Gardner | Licensed Practical Nurse | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-12-13 |
1619511417 | Andrea Santa Maria | Counselor | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-11-05 |
1871135921 | Jordann Moore | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-10-10 |
1386293546 | Stacy Hansen | Technician | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-09-10 |
1528617255 | Melba Buchanan | Counselor | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-09-05 |
1225686850 | Amy Jo Doiel | Case Manager/Care Coordinator | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-08-27 |
1023676624 | Ann Larose | Specialist | 620 Gallatin Pike S, Madison, TN 37115-4013 | 2019-05-30 |
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NPI | Name | Taxonomy | Address | Enumeration |
---|---|---|---|---|
1023675212 | Kennedy Wayne Germany Jr. | Specialist/Technologist | 813 Seashell Cove, Madison, TN 37115 | 2019-05-22 |
1497211387 | Latasha Monique Williams | Social Worker | Patriot Place (va), 314 Williams Avenue, Ste. 100, Madison, TN 37115 | 2019-02-15 |
1659866481 | Amanda Elliott | Pharmacist | 109 Gallatin Rd, Madison, TN 37115 | 2018-06-25 |
1760938492 | Larry Cox | Case Manager/Care Coordinator | 620 S. Gallatin Pike, Madison, TN 37115 | 2016-09-01 |
1407202799 | National Vision, Inc. | Technician/Technologist | 1785 Gallatin Pike N, Madison, TN 37115 | 2016-05-05 |
1992190193 | Emily Tibbs | Case Manager/Care Coordinator | 620 Gallatin Pike, Madison, TN 37115 | 2015-04-03 |
1164829982 | Laura Boswell | Case Manager/Care Coordinator | 620 Gallatin Pike South, Madison, TN 37115 | 2014-11-21 |
1720498058 | Edward Andrew Roberts | Chiropractor | 1710 Gallatin Pike N, Madison, TN 37115 | 2014-05-08 |
1700296217 | Lamonia Merritt | Student in an Organized Health Care Education/Training Program | 645 Cheyenne Blvd, Madison, TN 37115 | 2014-05-06 |
1629497656 | Corey Joseph Cloud | Dentist | 500 Lentz Dr Ste 40, Madison, TN 37115 | 2014-04-07 |
Find all providers in zip 37115 |
Taxonomy Code | 103TB0200X |
Grouping | Behavioral Health & Social Service Providers |
Classification | Psychologist |
Specialization | Cognitive & Behavioral |
Definition to come... |
Notes: [1/1/2007: title modified] |
NPI | Name | Taxonomy | Address | Enumeration |
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1720120959 | Advanced Psychological Innovations | Psychologist | 6418 Normandy Ln, Suite 215, Madison, WI 53719-1149 | 2007-02-13 |
1548279045 | Dolores Kluppel Vetter | Psychologist | 6401 Odana Rd, Ste A, Madison, WI 53719-1126 | 2006-08-05 |
1073813804 | Michelle R Gryczkowski | Psychologist | 6001 Research Park Blvd, Madison, WI 53719-1176 | 2010-10-27 |
1982874525 | Irene P Bartell | Psychologist | 6418 Normandy Ln, Suite 215, Madison, WI 53719-1149 | 2008-03-11 |
1962574665 | Jeanne Marie Behrend | Psychologist | 5610 Medical Circle, Suite 25, Madison, WI 53719-1295 | 2006-11-15 |
1538195607 | Steven R Stein | Psychologist | 700 Ray O Vac Dr, Madison, WI 53711 | 2006-06-23 |
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1639331168 | Julie Ann Demarco | Psychologist | 8284 Clinton Way Ln, Cordova, TN 38018-6305 | 2008-06-26 |
1669633384 | Susan Kay Fuhr | Psychologist | 141 N Martinwood Rd, Your Journeys 104-7, Knoxville, TN 37923-5137 | 2008-06-25 |
1225208531 | Michelle Mcatee | Psychologist | 109 Holiday Ct Ste D6, Franklin, TN 37067-1311 | 2008-03-04 |
1598934762 | Dara T. Kline | Psychologist | 1637 Niggs Creek Rd, Oneida, TN 37841-6417 | 2008-02-21 |
1891975397 | Dawn M Stewart | Psychologist | 214 S Greer St, Memphis, TN 38111-3434 | 2007-11-13 |
1346420809 | Jeffrey Brian Smith | Psychologist | 4055 N Park Loop Ste 1000, Memphis, TN 38152-4869 | 2007-11-13 |
1578767208 | Karen Swoboda | Psychologist | 106 Parkland Cir, Clarksville, TN 37043-6846 | 2007-06-14 |
1902940349 | The Habilitation Corporation | Psychologist | 1396 Beaver Trail Dr, Cordova, TN 38016-9601 | 2007-02-19 |
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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.