Shannon Lynn Tucker, M.A., CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

4977 Issued in NC

Practice address

210 E Woodlawn Rd
Suite 150
Charlotte, NC 28217-2202

Phone

(704) 523-8027

Fax

(704) 523-8031

NPI assigned

Oct 20, 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 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Arts

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.

• Charlotte Speech and Hearing Center, Inc.

  • Speech-Language Pathologist
  • Charlotte, NC
  • NPI 1578646865
  NPD (past) Authorized official

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

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1346322112",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "210 E WOODLAWN RD",
            "address_2": "SUITE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172202",
            "telephone_number": "704-523-8027",
            "fax_number": "704-523-8031"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "210 E WOODLAWN RD",
            "address_2": "SUITE 150",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282172202",
            "telephone_number": "704-523-8027",
            "fax_number": "704-523-8031"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SHANNON",
        "middle_name": "LYNN",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "4977",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7411674",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kathy Renee Tucker
• Margaret Mary Tucker, LCSWA
• Myron R Tucker, DDS
• Peter Loren Tucker, MD
• Rina G Tucker, LCMHCA
• Walter Robert Tucker, MD
• William Stuart Tucker Jr., MD
• Alexandra Tulloch, LCMHC
• Danielle Y Tulloch, RN
• Sarah Flora Tuluenga

• All providers in Charlotte, NC
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.