Tara Deann Wilks, MS, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

3119 Issued in OK

Practice address

1200 E Pecan St
Altus, OK 73521-6141

Phone

(580) 477-7226

Fax

(580) 477-7206

NPI assigned

Jun 12, 2008

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: rehab@direct.jcmh.com

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.

• Jackson County Memorial Hospital Authority

  • General Acute Care Hospital
  • Altus, OK
  • NPI 1093763781
  NPD (past)

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

{
    "created_epoch": "1213228800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1700524800000",
    "number": "1205096211",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 E TAMARACK RD",
            "address_2": "APT 205",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735219766",
            "telephone_number": "580-477-7226",
            "fax_number": "580-477-7206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1200 E PECAN ST",
            "city": "ALTUS",
            "state": "OK",
            "postal_code": "735216141",
            "telephone_number": "580-477-7226",
            "fax_number": "580-477-7206"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILKS",
        "first_name": "TARA",
        "middle_name": "DEANN",
        "credential": "MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-06-12",
        "last_updated": "2023-11-21",
        "certification_date": "2023-11-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "OK",
            "license": "3119",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "201092470A",
            "state": "OK"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rehab@direct.jcmh.com",
            "affiliation": "N",
            "address_1": "1200 E Pecan St",
            "city": "Altus",
            "state": "OK",
            "country_code": "US",
            "postal_code": "735216141",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Allissa Marie White, MD
• Shelby White
• Whitney N Lamb, DDS Family Dentistry
• Jennifer Rechelle Wiley, RBT
• Tim Wilkins, D.MIN.
• Williams Medical Group Practice, LLC (Xpress Wellness Urgent Care)
• Jacqueline Chanthay Williams
• Justyn Williams, PHARM.D.
• Misty Gail Williams, APRN-CNP
• Christina Lee Williamson, FNP-BC

• Speech-Language Pathologist in Altus, OK
• Providers in Altus, OK by specialty
• Speech-Language Pathologist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 21, 2023; 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.