Doreen Anne Tierney

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SP00543 Issued in RI

Practice address

35 State Ave
Faribault, MN 55021-6368

Phone

(507) 497-3790

NPI assigned

Mar 20, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Interoperability endpoints

• Direct secure messaging: dtierney397552@excellian.direct.allina.com

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585785600000",
    "number": "1356466197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 STATE AVE STE 2",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216369",
            "telephone_number": "507-497-3790"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 STATE AVE",
            "city": "FARIBAULT",
            "state": "MN",
            "postal_code": "550216368",
            "telephone_number": "507-497-3790"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIERNEY",
        "first_name": "DOREEN",
        "middle_name": "ANNE",
        "name_prefix": "Miss",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-03-20",
        "last_updated": "2020-04-02",
        "certification_date": "2020-04-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "MA",
            "license": "6195",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CT",
            "license": "003440",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "RI",
            "license": "SP00543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deborah Ann Thibodeau, RPH
• Thomas Backenstose
• Jordan Thompson
• Thomas Thornton, ABS
• Peter Jon Thurnau
• Angela Lynn Timm, DO
• Nicholas Alexander Tobianski, PA-C
• Kennedy Todd
• Amanda Toegel
• Top Talent Transportation L.L.C

• Speech-Language Pathologist in Faribault, MN
• Providers in Faribault, MN by specialty
• Speech-Language Pathologist in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 2, 2020; 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.