Individual provider Active NPI

Angela Reed Tull, M.A., CCC-SLP

  • Speech-Language Pathologist
  • Memphis, TN
National Provider Identifier
1740463025
Registry record updated Dec 10, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SP0000002446 Issued in TN
Practice address
5469 Southwood Dr
Memphis, TN 38120-1928
Phone
(901) 761-0021
NPI assigned
Dec 10, 2007
Last updated
Dec 10, 2007By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2007

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 SP0000002446 TN Primary

Addresses

Primary practice location

5469 Southwood Dr
Memphis, TN 38120-1928

Mailing address

4675 Lorece Ave
Memphis, TN 38117-2513
Phone (901) 683-0646

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
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
SP0000002446TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Rehab at Your Place, LLC Speech-Language Pathologist Past Accepting new patients
Rehab at Your Place Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1197244800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1197244800000",
    "number": "1740463025",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4675 LORECE AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381172513",
            "telephone_number": "901-683-0646"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5469 SOUTHWOOD DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381201928",
            "telephone_number": "901-761-0021"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "ANGELA",
        "middle_name": "REED",
        "credential": "M.A., CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-12-10",
        "last_updated": "2007-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "SP0000002446",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Memphis, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 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.