Tara J Krisher, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146.013525 Issued in IL

Practice address

940 W Fremont St # 205
Galesburg, IL 61401-2558

Phone

(309) 973-2496

NPI assigned

Aug 24, 2018

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other names 1

• Tara Dewitt Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1535068800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722556800000",
    "number": "1215418561",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "940 W FREMONT ST",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012558",
            "telephone_number": "309-973-2496"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "940 W FREMONT ST # 205",
            "city": "GALESBURG",
            "state": "IL",
            "postal_code": "614012558",
            "telephone_number": "309-973-2496"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1018 S Farnham St",
            "address_purpose": "LOCATION",
            "city": "Galesburg",
            "state": "IL",
            "postal_code": "614016324",
            "country_code": "US",
            "telephone_number": "309-973-2012",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "KRISHER",
        "first_name": "TARA",
        "middle_name": "J",
        "credential": "CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-08-24",
        "last_updated": "2024-08-02",
        "certification_date": "2024-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146.013525",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "DEWITT",
            "credential": "CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Gabriel J Koch, DO
• Thomas Michael Kovacik, DC
• Michael R Kovanda, M.A.
• Kasey Lynn Kramer, APN
• Alissa Lee Kremer, PA-C
• Michelle M Kroll
• Kelley A Krug, PA C
• Beata Kwiatkowska, PHARMD
• Annalise Laaker, MD
• Ladner and Jain Orthodontics, LLP

• Speech-Language Pathologist in Galesburg, IL
• Providers in Galesburg, 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 Aug 2, 2024; 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.