Tara Thor

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Practice address

2200 52ND Ave
Moline, IL 61265-6308

Phone

(309) 797-2900

NPI assigned

Sep 16, 2020

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in IL, IA2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Mental Health Counselor

Education

Other, 2020

Medicare assignment

May accept Medicare assignment

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Rock Island, IL
  • NPI 1598759292
  Medicare reassignment
• Community Health Care, Inc.

  • Federally Qualified Health Center (FQHC)
  • Davenport, IA
  • NPI 1932193224
  Medicare reassignment
• Advanced Cardiovascular Consultants,SC

  • Specialist
  • Moline, IL
  • NPI 1588718910
  NPD

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

{
    "created_epoch": "1600214400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1721692800000",
    "number": "1447866447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2200 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656308",
            "telephone_number": "309-797-2900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2200 52ND AVE",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612656308",
            "telephone_number": "309-797-2900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOR",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-16",
        "last_updated": "2024-07-23",
        "certification_date": "2024-07-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Moline",
            "affiliation": "N",
            "address_1": "2200 52nd Ave",
            "city": "Moline",
            "state": "IL",
            "country_code": "US",
            "postal_code": "612656308",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• William J Theisen, D.C.
• Andrea Themas
• Diana Theusch, PHARMD
• Thomas D Ade MD PLLC
• Bryce Thomsen, DPT
• Jon Thoreson, PT
• Kimberly S. Thrush, LCSW, LISW
• Tiffany Zimmerman DC PC
• Craig P. Tillman, M.D.
• Laura Timmerman

• Mental Health Counselor in Moline, IL
• Providers in Moline, IL by specialty
• Mental Health Counselor in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 23, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.