Tara Thiems

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

242.003221 Issued in IL

Practice address

634 N Main St
Suite 3
O Fallon, IL 62269-3746

Phone

(618) 632-4222

NPI assigned

Sep 2, 2014

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Abc Pediatric Therapy, LLC

  • Speech-Language Pathologist
  • O Fallon, IL
  • NPI 1124044698
  NPD (past)

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

{
    "created_epoch": "1409616000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409616000000",
    "number": "1144620774",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 FOX HILL CT",
            "city": "EDWARDSVILLE",
            "state": "IL",
            "postal_code": "620255736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "634 N MAIN ST",
            "address_2": "SUITE 3",
            "city": "O FALLON",
            "state": "IL",
            "postal_code": "622693746",
            "telephone_number": "618-632-4222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THIEMS",
        "first_name": "TARA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-02",
        "last_updated": "2014-09-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "242.003221",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• The Caring Group
• The Dental Studio of Southern Illinois
• The Stauder Group LLC
• Therapy With Tiffany, PLLC
• Shelby Kay Thiems
• Kellsey R Thole, NP
• Thomas Counseling Services, LLC
• Carolyn Thomas, RBT
• Alyse Marie Thompson, RBT
• Kylee Elizabeth Thompson

• Speech-Language Pathologist in O Fallon, IL
• Providers in O Fallon, IL by specialty
• Speech-Language Pathologist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 2, 2014; 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.