Active NPI
Portia Tucker
- Speech-Language Pathologist
- Laurens, SC
National Provider Identifier
1114443603
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 6294
- Practice address
- 301 Henry St
Laurens, SC 29360-1746 - Phone
- (864) 984-3067
- NPI assigned
- Aug 17, 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 | 6294 | SC | Primary |
Addresses
Primary practice location
301 Henry St
Laurens, SC 29360-1746
Mailing address
601 Lucas Ave
Laurens, SC 29360-2149
Phone (864) 984-3986
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in SC
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Qualified Speech Language Pathologist
- Education
- Other, 2017
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
800 N Lake Dr
Lexington, SC 29072-2903
Phone (877) 407-3422
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6294 | SC | MD | Professional Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Fox Rehabilitation Services of South Carolina, LLC | Speech-Language Pathologist | Current | Accepting new patients |
Locations
7 Carnegie Plz
Cherry Hill, NJ 08003
Organizations & group practices 2
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.
-
- Physical Therapist
- Lexington, SC
- NPI 1902133689
Speech-Language Pathologist
-
- Physical Therapist
- Gaffney, SC
- NPI 1437765583
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1502928000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1502928000000",
"number": "1114443603",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "601 LUCAS AVE",
"city": "LAURENS",
"state": "SC",
"postal_code": "293602149",
"telephone_number": "864-984-3986"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 HENRY ST",
"city": "LAURENS",
"state": "SC",
"postal_code": "293601746",
"telephone_number": "864-984-3067"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "PORTIA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2017-08-17",
"last_updated": "2017-08-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "SC",
"license": "6294",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Laurens, SC
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 17, 2017; 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.