Vanessa Balthrop Tucker, M.S. CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA8555 Issued in FL

Practice address

95326 Springhill Rd
Fernandina Beach, FL 32034-9413

Phone

(904) 206-4487

NPI assigned

Oct 8, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science

Practice roles

Locations

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.

• Broad River Rehabilitation

  • Occupational Therapist
  • Charlotte, NC
  • NPI 1902317589

  FL, Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1223424000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1223424000000",
    "number": "1265683288",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "95326 SPRINGHILL RD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320349413"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "95326 SPRINGHILL RD",
            "city": "FERNANDINA BEACH",
            "state": "FL",
            "postal_code": "320349413",
            "telephone_number": "904-206-4487"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "VANESSA",
        "middle_name": "BALTHROP",
        "name_prefix": "Mrs.",
        "credential": "M.S. CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-10-08",
        "last_updated": "2008-10-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA8555",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Tomlinson, DMD
• Mike Townsend
• Trans-Comp Medical Corp
• Anna Beamer Trent, RDN, LDN
• Edward Dominick Tribuzio, M.D.
• Heather Rae Tuerschmann, PT, DPT
• Diana R Twiggs, M.D.
• University of Florida Jacksonville Physicians, Inc
• George Robert Vanetta, D.M.D.
• Alison Marion Varhol, MS, RD, LD/N

• Speech-Language Pathologist in Fernandina Beach, FL
• Providers in Fernandina Beach, 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 Oct 8, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.