Nicole Tucker Gathwright, M.S., C.C.C.-S.L.P.

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA 5826 Issued in FL

Practice address

1215 E Orange St
Lakeland, FL 33801-5762

Phone

(863) 802-3800

Fax

(863) 802-0480

NPI assigned

Aug 31, 2006

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 4

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Pediatric Therapy Services Inc

  • Clinic/Center
  • Lakeland, FL
  • NPI 1407834021

  Speech-Language Pathologist

  NPD (past)

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1297641600000",
    "number": "1235240201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1215 E ORANGE ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015762",
            "telephone_number": "863-802-3800",
            "fax_number": "863-802-0480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1215 E ORANGE ST",
            "city": "LAKELAND",
            "state": "FL",
            "postal_code": "338015762",
            "telephone_number": "863-802-3800",
            "fax_number": "863-802-0480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GATHWRIGHT",
        "first_name": "NICOLE",
        "middle_name": "TUCKER",
        "name_prefix": "Mrs.",
        "credential": "M.S., C.C.C.-S.L.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-08-31",
        "last_updated": "2011-02-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA 5826",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSURE",
            "identifier": "SA 5826",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "IND CITRUS ID#",
            "identifier": "13425301",
            "state": "FL"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "886461600",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS FL",
            "identifier": "Y905L",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lisa Gartrell, CRNP-PMH
• Bruce Howard Garver, M.S.
• Erin Fagan Garza, APRN
• Philip D Garzarelli, LMHC, CAP
• Latesha Vontrice Gaskins
• Shelby Beatrice Mooney Gaudette, LCSW
• Morissa Gaughran, DO
• Andrew Christian Gaugler, D.O.
• Sarah M. Gaugler, D.O.
• Araceli Gauna-Scattolini, LMHC

• Speech-Language Pathologist in Lakeland, FL
• Providers in Lakeland, FL by specialty
• Speech-Language Pathologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.