Provider Demographics
NPI:1033644083
Name:COMPREHENSIVE NEUROLOGY CENTER, PLLC
Entity Type:Organization
Organization Name:COMPREHENSIVE NEUROLOGY CENTER, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MRS
Authorized Official - First Name:JULIE
Authorized Official - Middle Name:
Authorized Official - Last Name:SCHNEIDER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:608-217-9776
Mailing Address - Street 1:2548 RIDEOUT LN
Mailing Address - Street 2:
Mailing Address - City:MURFREESBORO
Mailing Address - State:TN
Mailing Address - Zip Code:37128-7686
Mailing Address - Country:US
Mailing Address - Phone:615-410-4990
Mailing Address - Fax:615-410-4250
Practice Address - Street 1:2548 RIDEOUT LN
Practice Address - Street 2:
Practice Address - City:MURFREESBORO
Practice Address - State:TN
Practice Address - Zip Code:37128
Practice Address - Country:US
Practice Address - Phone:615-410-4990
Practice Address - Fax:615-410-4250
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-04-27
Last Update Date:2018-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN45893174400000X
2084N0400X, 2084P2900X, 208VP0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208VP0000XAllopathic & Osteopathic PhysiciansPain MedicinePain MedicineGroup - Multi-Specialty
No174400000XOther Service ProvidersSpecialistGroup - Multi-Specialty
No2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurologyGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
1013245588OtherINDIVIDUAL NPI - MISTIE GERMEK, PHD
10370G1506OtherGROUP MEDICARE PTAN NUMBER
19321240951OtherINDIVIDUAL NPI - JOHANNA JIRIKOVEC, NP
1215273917OtherINDIVIDUAL NPI - DANA CARTER, NP
1619217106OtherINDIVIDUAL NPI - MEGAN CHILDERS, NP
TN1525675Medicaid
1538414305OtherINDIVIDUAL NPI - MONICA SATTERWHITE, NP
1588944532OtherGROUP NPI NUMBER
1730145285OtherINDIVIDUAL NPI - JOHN SCHNEIDER, MD
1104365964OtherINDIVIDUAL NPI - AMANDA MASON, NP
44D2099106OtherCLIA WAIVER #