Tabitha Berry Phillips, MA, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

2204 Issued in SC

Practice address

203 N Maple Street
Suite 10
Simpsonville, SC 29681-2449

Phone

(864) 757-9846

Fax

(864) 757-9847

NPI assigned

May 2, 2007

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 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Arts

State licenses

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.

• Sand Coast Rehab Physical Therapy Inc

  • Physical Therapist
  • Lakewood, NJ
  • NPI 1639766603

  CA, Speech-Language Pathologist

  Medicare reassignment NPD

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

{
    "created_epoch": "1178064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340064000000",
    "number": "1285855627",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "203 N MAPLE STREET",
            "address_2": "SUITE 10",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812449",
            "telephone_number": "864-757-9846",
            "fax_number": "864-757-9847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "203 N MAPLE STREET",
            "address_2": "SUITE 10",
            "city": "SIMPSONVILLE",
            "state": "SC",
            "postal_code": "296812449",
            "telephone_number": "864-757-9846",
            "fax_number": "864-757-9847"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "TABITHA",
        "middle_name": "BERRY",
        "name_prefix": "Mrs.",
        "credential": "MA, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-02",
        "last_updated": "2012-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "2204",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "SA0445",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Joyce M Petty, RN
• Emily Elizabeth Phillips, MD
• Jessica Wilkerson Phillips, FNP
• Judith R Phillips
• Lakisha Phillips
• Kathryn Alicia Pierce
• Taryn Hopkins Piffard, PT
• Lisbeth Pittman, RBT
• John Pitzulo, D.C
• Chelynne Plaisted

• Speech-Language Pathologist in Simpsonville, SC
• Providers in Simpsonville, SC by specialty
• Speech-Language Pathologist in South Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 2012; 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.