Melissa Fuqua, MA-CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

5603 Issued in TN

Practice address

146 Timber Creek Dr Ste 101
Cordova, TN 38018-4396

Phone

(901) 654-5693

Fax

(855) 978-0933

NPI assigned

Oct 30, 2012

Last updated

Feb 28, 2025By the provider in NPPES

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• MTG2

  dba Midsouth Therapy Group

  • Speech-Language Pathologist
  • Cordova, TN
  • NPI 1396476081
  NPD (past)

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

{
    "created_epoch": "1351555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1740700800000",
    "number": "1316291313",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "146 TIMBER CREEK DR STE 101",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184396",
            "telephone_number": "901-654-5693",
            "fax_number": "855-978-0933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "146 TIMBER CREEK DR STE 101",
            "city": "CORDOVA",
            "state": "TN",
            "postal_code": "380184396",
            "telephone_number": "901-654-5693",
            "fax_number": "855-978-0933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FUQUA",
        "first_name": "MELISSA",
        "credential": "MA-CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2012-10-30",
        "last_updated": "2025-02-28",
        "certification_date": "2025-02-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "5603",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "5603",
            "state": "TN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Barry Steven Friedman, PTA
• Terkessa Frison, LMSW
• Liusong Jason Fu, M.D.
• Kayla Aariana Fuller
• Functional Independence Home Care, Inc
• Pamela Denise Fuqua, APN
• Ranjula Gadhock
• Cynthia Gaia
• Jessica Ann Gaines Osborn, LPC-MHSP, NCC
• Michael Wayne Gaither, D.D.S.

• Speech-Language Pathologist in Cordova, TN
• Providers in Cordova, TN by specialty
• Speech-Language Pathologist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2025; 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.