Kelly Tanner

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

Practice address

9120 Springbrook Dr NW
Coon Rapids, MN 55433-5845

Phone

(952) 767-5900

NPI assigned

Aug 21, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Fraser Child and Family Center

  • Adolescent and Children Mental Health Clinic/Center
  • Minneapolis, MN
  • NPI 1609922194
  NPD
• Fraser

  • Rehabilitation Clinic/Center
  • Richfield, MN
  • NPI 1063568574
  NPD (past)
• Eastern New Mexico University

  • Speech-Language Pathologist
  • Portales, NM
  • NPI 1356115273
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1503273600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649894400000",
    "number": "1104342187",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "952-767-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "9120 SPRINGBROOK DR NW",
            "city": "COON RAPIDS",
            "state": "MN",
            "postal_code": "554335845",
            "telephone_number": "952-767-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "KELLY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-21",
        "last_updated": "2022-04-14",
        "certification_date": "2022-04-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Michele L Tafoya, DDS
• Tara Tait, PA-C
• Paul J Talarico, PA-C
• Annie Tan, MD
• Sabrina Jia Tang, PA
• Tany Logistics Group LLC
• Jillian Tanych, DPT
• Megan Kathleen Tappe
• Phurbu Tara, CNP
• Alyssa Rose Taylor

• Speech-Language Pathologist in Coon Rapids, MN
• Providers in Coon Rapids, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2022; 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.