Individual provider Active NPI

Tara Nicole Feather, MSP, CCC-SLP

  • Speech-Language Pathologist
  • Greenville, SC
National Provider Identifier
1366996753
Registry record updated Apr 1, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
5979 Issued in SC
Practice address
50 Bear Dr
Greenville, SC 29605-4458
Phone
(864) 241-6222
NPI assigned
Aug 15, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 1, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 5979 SC Primary

Addresses

Primary practice location

50 Bear Dr
Greenville, SC 29605-4458

Mailing address

23 Itasca Dr
Greenville, SC 29609-5000
Phone (864) 517-2224

Other practice location 1

29 N Academy St
Greenville, SC 29601-2629
Phone (864) 331-1364

Other names 1

  • Tara Nicole Watters Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
5979SCMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1471219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585699200000",
    "number": "1366996753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "23 ITASCA DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296095000",
            "telephone_number": "864-517-2224"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "50 BEAR DR",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296054458",
            "telephone_number": "864-241-6222"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "29 N Academy St",
            "address_purpose": "LOCATION",
            "city": "Greenville",
            "state": "SC",
            "postal_code": "296012629",
            "country_code": "US",
            "telephone_number": "864-331-1364",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FEATHER",
        "first_name": "TARA",
        "middle_name": "NICOLE",
        "credential": "MSP, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-15",
        "last_updated": "2020-04-01",
        "certification_date": "2020-04-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "5979",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "TARA",
            "last_name": "WATTERS",
            "middle_name": "NICOLE",
            "credential": "MSP, CCC-SLP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Greenville, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 1, 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.