Individual provider Active NPI

Heather Tanner, MS,CCC-SLP

  • Speech-Language Pathologist
  • La Crosse, WI
National Provider Identifier
1689736753
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
2802-154 Issued in WI
Practice address
2501 Shelby Rd
La Crosse, WI 54601-8037
Phone
(608) 788-5700
NPI assigned
Dec 15, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 2802-154 WI Primary

Addresses

Primary practice location

2501 Shelby Rd
La Crosse, WI 54601-8037

Mailing address

415 N L St
Sparta, WI 54656-1639

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250829000774 TX Practitioner - Qualified Speech Language Pathologist 2769983907 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
2802-154WIMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jul 28, 2025 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist CurrentSince Jul 28, 2025 Accepting new patients
Aegis Group Practice LLC Speech-Language Pathologist Current Accepting new patients

Locations

800 Whitley Rd
Keller, TX 76248
Phone (817) 357-7181

Organizations & group practices 26

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.

View all 26

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Aegis Group Practice LLC 399 clinicians

Practice addresses (Care Compare)

4243 Thousand Oaks Dr
San Antonio, TX 78217-1801
Phone (830) 359-8194

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1689736753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 N L ST",
            "city": "SPARTA",
            "state": "WI",
            "postal_code": "546561639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2501 SHELBY RD",
            "city": "LA CROSSE",
            "state": "WI",
            "postal_code": "546018037",
            "telephone_number": "608-788-5700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TANNER",
        "first_name": "HEATHER",
        "credential": "MS,CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-15",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "WI",
            "license": "2802-154",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in La Crosse, WI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.