Individual provider Active NPI

Tamara Williard, SLP,MA,CCC-SLP

  • Speech-Language Pathologist
  • Fort Worth, TX
National Provider Identifier
1144361502
Registry record updated Mar 21, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
19233 Issued in TX
Practice address
1919 8TH Ave
Fort Worth, TX 76110-1358
Phone
(940) 595-1859
NPI assigned
Feb 9, 2007
Last updated
Mar 21, 2014By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 21, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 19233 TX Primary

Addresses

Primary practice location

1919 8TH Ave
Fort Worth, TX 76110-1358

Mailing address

1919 8TH Ave
Fort Worth, TX 76110-1358
Phone (940) 595-1859

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250312003344 TX Practitioner - Qualified Speech Language Pathologist 0648791186 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1999
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Matt Bonander LLCGroup PAC ID 3274928023, 7 clinicians

Practice addresses (Care Compare)

4118 Herdsman Dr
Krum, TX 76249-1556
Phone (940) 535-8105

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Arts

Practice roles

OrganizationSpecialtyStatusNew patients
Matt Bonander LLC CurrentSince Feb 1, 2025 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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1170979200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1395360000000",
    "number": "1144361502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1919 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101358",
            "telephone_number": "940-595-1859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1919 8TH AVE",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761101358",
            "telephone_number": "940-595-1859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILLIARD",
        "first_name": "TAMARA",
        "credential": "SLP,MA,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-09",
        "last_updated": "2014-03-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TX",
            "license": "19233",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 21, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.