Individual provider Active NPI

Jessica Morgan Tucker, MM, MS, CCC-SLP

  • Speech-Language Pathologist
  • Lafayette, IN
National Provider Identifier
1770253502
Registry record updated Sep 14, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
22007871A Issued in IN
Practice address
3001 S Creasy LN Ste B
Lafayette, IN 47905-5206
Phone
(765) 423-6885
NPI assigned
Sep 14, 2021
Last updated
Sep 14, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 14, 2021

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 22007871A IN Primary

Addresses

Primary practice location

3001 S Creasy LN Ste B
Lafayette, IN 47905-5206

Mailing address

3001 S Creasy LN Ste B
Lafayette, IN 47905-5206
Phone (765) 423-6885

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 Science

State licenses

LicenseStateTypeSpecialty
22007871AINMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1631577600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1631577600000",
    "number": "1770253502",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3001 S CREASY LN STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055206",
            "telephone_number": "765-423-6885"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3001 S CREASY LN STE B",
            "city": "LAFAYETTE",
            "state": "IN",
            "postal_code": "479055206",
            "telephone_number": "765-423-6885"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JESSICA",
        "middle_name": "MORGAN",
        "credential": "MM, MS, CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-14",
        "last_updated": "2021-09-14",
        "certification_date": "2021-09-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "IN",
            "license": "22007871A",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lafayette, IN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 14, 2021; 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.