Individual provider Active NPI

Tasheka D Gipson

  • Speech-Language Pathologist
  • Montgomery, AL
National Provider Identifier
1265624977
Registry record updated May 4, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP007650 Issued in GA
Practice address
712 Southlawn Dr
Montgomery, AL 36108-5371
Phone
(786) 797-0090
NPI assigned
Aug 16, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 4, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 21359 CA
Speech-Language Pathologist 235Z00000X SLP007650 GA Primary

Addresses

Primary practice location

712 Southlawn Dr
Montgomery, AL 36108-5371

Mailing address

712 Southlawn Dr
Montgomery, AL 36108-5371
Phone (786) 797-0090

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

State licenses

LicenseStateTypeSpecialty
21359CAMDSpeech-Language Pathologist
SLP007650GAMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1187222400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1462320000000",
    "number": "1265624977",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 SOUTHLAWN DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361085371",
            "telephone_number": "786-797-0090"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 SOUTHLAWN DR",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361085371",
            "telephone_number": "786-797-0090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GIPSON",
        "first_name": "TASHEKA",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-08-16",
        "last_updated": "2016-05-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "CA",
            "license": "21359",
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP007650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 4, 2016; 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.