Kimberly Ann Tucker, M. ED CCC-SLP

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

SA4450 Issued in FL

Practice address

5325 Choctaw St
St Augustine, FL 32092-0326

Phone

(904) 864-2573

NPI assigned

May 9, 2019

Last updated

May 9, 2019By the provider in NPPES

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

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1557360000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1557360000000",
    "number": "1548825185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5325 CHOCTAW ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920326"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5325 CHOCTAW ST",
            "city": "ST AUGUSTINE",
            "state": "FL",
            "postal_code": "320920326",
            "telephone_number": "904-864-2573"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KIMBERLY",
        "middle_name": "ANN",
        "name_prefix": "Mrs.",
        "credential": "M. ED CCC-SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-05-09",
        "last_updated": "2019-05-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "FL",
            "license": "SA4450",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "kimberly.tucker@presencelearning.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "5325 Choctaw St",
            "city": "St Augustine",
            "state": "FL",
            "country_code": "US",
            "postal_code": "320920326",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Ryan Tsai
• Ping Yan Lilian Tsui, MSN/FNP-C
• David B Tuchinsky, DC
• Carolyn Jean Tucker
• Jason Lamar Tucker
• Jerome Joel Tuitt, MD
• Robert Aaron Tummons, BA, MA, ADN, RN
• William Turnage, MD
• Turnbridge LLC
• Marian L Turner-Sharpton, LCSW

• Speech-Language Pathologist in St Augustine, FL
• Providers in St Augustine, 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 9, 2019; 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.