Tara Stark

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

146011310 Issued in IL

Practice address

1416 Maine St
Quincy, IL 62301-4261

Phone

(217) 223-8700

NPI assigned

Aug 22, 2017

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

Medicare fee-for-service enrollment

Enrolled in IL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Quincy Physicians & Surgeons Clinic, PLLC

  • Clinic/Center
  • Quincy, IL
  • NPI 1548234198
  Medicare reassignment NPD
• Quincy Physicians & Surgeons Clinic, PLLC

  • Durable Medical Equipment & Medical Supplies
  • Pittsfield, IL
  • NPI 1871794925
  NPD
• Quincy School District 172

  • Local Education Agency (LEA)
  • Quincy, IL
  • NPI 1215139761
  NPD (past)

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

{
    "created_epoch": "1503360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503360000000",
    "number": "1538685474",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6721 COLUMBUS RD",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623058681"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 MAINE ST",
            "city": "QUINCY",
            "state": "IL",
            "postal_code": "623014261",
            "telephone_number": "217-223-8700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STARK",
        "first_name": "TARA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-08-22",
        "last_updated": "2017-08-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IL",
            "license": "146011310",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• St. Vincent's Home, Inc.
• St. Vincents Home, Inc. (St Vincents Home)
• Jennifer A Stajduhar, MHP
• Tonya Stamper, CNP
• Nichole Suzanne Stanley
• Laura Starman
• Nicholas Anthony Starman, D.C.
• State Street Optical, Inc. (Lammers Optical)
• Joshua James Statler
• Jennifer Steel

• Speech-Language Pathologist in Quincy, IL
• Providers in Quincy, 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 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.