Active NPI
Heather Tanner, MS,CCC-SLP
- Speech-Language Pathologist
- La Crosse, WI
National Provider Identifier
1689736753
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2802-154
- 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
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| 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 ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
| License | State | Type | Specialty |
|---|---|---|---|
| 2802-154 | WI | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Aegis Group Practice LLC | Speech-Language Pathologist | Current | Accepting new patients |
| Aegis Group Practice LLC | Speech-Language Pathologist | Current | 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.
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Speech-Language Pathologist, TX
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- NPI 1275259798
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- NPI 1275304495
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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
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.