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TARA WITTROCK CCC/SLP
NPI 1871906891
Speech-Language Pathologist in Moose Lake, MN

Active since June 06, 2014
83.04/100
CMS Quality Rating
4791 COUNTY ROAD 10 STE 102, MOOSE LAKE, MN 55767(218) 485-2020(218) 485-2044 Get Directions Write a Review

NPPES record last updated: August 14, 2023. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Aug 14, 2023, May 18, 2021, Oct 3, 2018 (3 updates tracked since 2018).

About Tara Wittrock Ccc/slp NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TARA WITTROCK CCC/SLP (NPI 1871906891) is an individual speech-language pathologist provider in Moose Lake, Minnesota, licensed in Minnesota (9592) and active in the NPI registry since June 2014. She maintains a secondary practice location in Duluth.

NPPES Registry Identity

NPI1871906891
Entity TypeIndividualFemale
Primary Taxonomy235Z00000X
Provider Legal NameTARA WITTROCKCredential: CCC/SLP
Location Address4791 COUNTY ROAD 10 STE 102Moose Lake, MN 55767-9221
Mailing Address1939 Minnehaha Ave W Ste 300Saint Paul, MN 55104-1033 · (651) 748-4338 · Fax (651) 748-2892
Phone(218) 485-2020
Fax(218) 485-2044
Sole ProprietorNo
Enumeration DateJune 6, 2014
Last NPPES UpdateAugust 14, 20233 updates tracked since enumeration
NPPES CertifiedAugust 14, 2023
✔ NPI 1871906891 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySpeech-Language PathologistSpeech, Language and Hearing Service Providers
Taxonomy Code235Z00000X
License✔ Licensed in MN · 9592
Definition
The speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing.
4791 COUNTY ROAD 10 STE 102, Moose Lake, MN 55767
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Other Names 1

Former Name (1)Tara Dettle

Secondary Practice Location 1

Location 1407 E 3rd StDuluth, MN 55805 · Phone (218) 786-4000

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Medica.Insurance ›

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

83.04/100
MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program
Scored as part of a group practice
Quality80.04
Improvement Activities40

Other Providers at the Same Location NPPES 9

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

ALLIE MARIE HAKAMAKI DPT
Physical Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
JESSICA JOHNSON MPT
Physical Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
MRS. LYNN MARIE FOLSTED PT
Physical Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
LEANN POIRIER OTR/L
Occupational Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
LEAH PEDERSON OTR/L
Occupational Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
ALEXIS ARLENE METSO-OLSON
Massage Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
MARIE JEAN MCCABE DPT
Physical Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020
MRS. STEFFANY DRILLING MT
Massage Therapist
4791 COUNTY ROAD 10 STE 102
MOOSE LAKE, MN 55767
Carlton County (218) 485-2020

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Tara Wittrock's NPI number?

The NPI number for Tara Wittrock is 1871906891. It was assigned to this individual provider in the NPPES registry on June 6, 2014. The provider is also known as Tara Dettle.

Where is Tara Wittrock located?

Tara Wittrock practices at 4791 County Road 10 Ste 102, Moose Lake, MN 55767. The listed phone number is (218) 485-2020.

What is Tara Wittrock's specialty?

The primary specialty registered for this NPI is Speech-Language Pathologist with taxonomy code 235Z00000X.

What insurance does Tara Wittrock accept?

Health plans from Medica list Tara Wittrock as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Tara Wittrock was last updated on August 14, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.