Active NPI
Dawn Elizabeth Tallent, MA CCC-SLP
- Speech-Language Pathologist
- Sullivan, MO
National Provider Identifier
1760907596
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 2012026104
- Practice address
- 1132 Elmont Rd
Sullivan, MO 63080-1039 - Phone
- (573) 468-5171
- NPI assigned
- Aug 14, 2017
- Last updated
- Aug 14, 2017
- 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 | 2012026104 | MO | Primary |
Addresses
Primary practice location
1132 Elmont Rd
Sullivan, MO 63080-1039
Mailing address
36 Mimosa LN
Sullivan, MO 63080-3012
Phone (573) 259-4970
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| M465038917 | Medicaid | MO |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2012026104 | MO | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502668800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502668800000",
"number": "1760907596",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "36 MIMOSA LN",
"city": "SULLIVAN",
"state": "MO",
"postal_code": "630803012",
"telephone_number": "573-259-4970"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1132 ELMONT RD",
"city": "SULLIVAN",
"state": "MO",
"postal_code": "630801039",
"telephone_number": "573-468-5171"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TALLENT",
"first_name": "DAWN",
"middle_name": "ELIZABETH",
"name_prefix": "Mrs.",
"credential": "MA CCC-SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-14",
"last_updated": "2017-08-14",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "MO",
"license": "2012026104",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "M465038917",
"state": "MO"
}
],
"endpoints": [],
"other_names": []
}Other providers in Sullivan, MO
- Sullivan Dental Partnership LLC
- Sullivan Dental Partnership, LLC
- Sullivan Operations, LLC (Life Care Center of Sullivan)
- Sullivan Residential, LLC (Dunsford Court Assisted Living)
- Sandra Rachele Sumner, RDH
- Team Diagnostics LLC (Sullivan Open MRI)
- Thera-Peds, LLC
- Matthew J Tiefenbrunn, M.D.
- Sharon A Titter, MPT
- Amy E Torres, AGACNP-BC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 14, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.