Active NPI
Tanner Rose, SLP
- Speech-Language Pathologist
- London, KY
National Provider Identifier
1104448091
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 262936
- Practice address
- 181 Old Whitley Rd
London, KY 40744-8211 - Phone
- (606) 330-0223
- NPI assigned
- May 13, 2020
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 262936 | KY | Primary |
Addresses
Primary practice location
181 Old Whitley Rd
London, KY 40744-8211
Mailing address
181 Old Whitley Rd
London, KY 40744-8211
Phone (606) 330-0223
Other practice location 1
212 Thompson Poynter Rd
London, KY 40741-7238
Phone (606) 330-0223 ext. 60633
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 262936 | KY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lake Cumberland Pediatric Therapy, LLC | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Somerset, KY
- NPI 1962058669
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1589328000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1618963200000",
"number": "1104448091",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "181 OLD WHITLEY RD",
"city": "LONDON",
"state": "KY",
"postal_code": "407448211",
"telephone_number": "606-330-0223",
"fax_number": "606-330-0228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "181 OLD WHITLEY RD",
"city": "LONDON",
"state": "KY",
"postal_code": "407448211",
"telephone_number": "606-330-0223"
}
],
"practiceLocations": [
{
"address_1": "212 Thompson Poynter Rd",
"address_purpose": "LOCATION",
"city": "London",
"state": "KY",
"postal_code": "407417238",
"country_code": "US",
"telephone_number": "606-330-0223 x60633",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "ROSE",
"first_name": "TANNER",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-05-13",
"last_updated": "2021-04-21",
"certification_date": "2021-04-21",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "KY",
"license": "262936",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in London, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 21, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.