Tamara R Fourth, M.S, CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA17846 Issued in FL

Practice address

3020 Mesa Verde Dr Apt 1906
Orlando, FL 32837-4369

Phone

(407) 435-0191

NPI assigned

Feb 20, 2020

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

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.

• Fourth Enhanced Speech Therapy Services, LLC

  • Speech-Language Pathologist
  • Orlando, FL
  • NPI 1154946366

  Single Specialty

  NPD Authorized official

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

{
    "created_epoch": "1582156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1589241600000",
    "number": "1356974190",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3020 MESA VERDE DR APT 1906",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3020 MESA VERDE DR APT 1906",
            "city": "ORLANDO",
            "state": "FL",
            "postal_code": "328374369",
            "telephone_number": "407-435-0191"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FOURTH",
        "first_name": "TAMARA",
        "middle_name": "R",
        "credential": "M.S, CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-02-20",
        "last_updated": "2020-05-12",
        "certification_date": "2020-05-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA17846",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Four Season Dental LLC
• Keith Fournet, MD
• Kevin Fournet, MD
• Alyssa Fournier, BCBA
• Fourth Enhanced Speech Therapy Services, LLC
• Rhonda Foust, PHARMD
• Andrea Louise Fowler
• David Fowler
• Dawn Michelle Fowler, APRN
• Kimberly Ranea Fowler, M.S

• Speech-Language Pathologist in Orlando, FL
• Providers in Orlando, 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 May 12, 2020; 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.