Kimberly Tallon

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093770 Issued in IA

Practice address

3375 Lake Ridge Dr
Dubuque, IA 52003-7864

Phone

(563) 207-8932

NPI assigned

Jan 13, 2015

Last updated

Oct 24, 2019By the provider in NPPES

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

Opted out of Medicare

Yes, effective Oct 1, 2023 through Oct 1, 2027

Medicare enrollment (NPD)

Not 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.

• Statera LLC

  • Primary Care Clinic/Center
  • Dubuque, IA
  • NPI 1689172751
  NPD
• Wellness Iowa PLLC

  dba Edison Eating Disorder and Mental Health Services

  • Clinical Social Worker
  • West Des Moines, IA
  • NPI 1952177693
  NPD

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

{
    "created_epoch": "1421107200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1571875200000",
    "number": "1740679745",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2345 POPLAR ST",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520014136",
            "telephone_number": "515-520-7877"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3375 LAKE RIDGE DR",
            "city": "DUBUQUE",
            "state": "IA",
            "postal_code": "520037864",
            "telephone_number": "563-207-8932"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "126 E Chestnut St",
            "address_2": "Replogole Counseling Center",
            "address_purpose": "LOCATION",
            "city": "Chicago",
            "state": "IL",
            "postal_code": "606112014",
            "country_code": "US",
            "telephone_number": "312-787-8425 x2242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TALLON",
        "first_name": "KIMBERLY",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-01-13",
        "last_updated": "2019-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "IA",
            "license": "093770",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "IA",
            "license": "093770",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Marie Swenson, CFY-SLP
• Synergist, LLC (Synergist Physical Therapy and Performance)
• Peter Joseph Szeibel, M.D.
• Victoria Szelepinski
• Kara Takes
• Jessica Ann Tartaglione, PSY.D.
• Kiley Tasset
• Brianna Tauber
• Abigail Callista Tebbe, D.C.
• Ted Murray

• Clinical Social Worker in Dubuque, IA
• Providers in Dubuque, IA by specialty
• Clinical Social Worker in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.