NPIMap

Individual provider Active NPI

Tiffany Morris Scandrett, CCC-SLP

  • Speech-Language Pathologist
  • Macon, GA
National Provider Identifier
1801967427
Registry record updated Jul 20, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
SLP005793 Issued in GA
Practice address
1385 Oglethorpe St
Macon, GA 31201-1511
Phone
(478) 746-1037
Fax
(478) 746-1642
NPI assigned
Nov 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 20, 2011

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 SLP005793 GA Primary

Addresses

Primary practice location

1385 Oglethorpe St
Macon, GA 31201-1511

Mailing address

236 Kimmeridge Dr
Macon, GA 31220-2672
Phone (478) 714-3807

Other identifiers 3

IdentifierTypeStateIssuer
305467OtherGAWELLCARE PROVIDER ID
167270852AMedicaidGA
20-0847484OtherGATAX IDENTIFICATION NUMBER

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
SLP005793GAMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Communication Dynamics Speech-Language Pathologist Past Accepting new patients
Communication Dynamics Pediatric Therapy, LLC Speech-Language Pathologist 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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1163376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311120000000",
    "number": "1801967427",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "236 KIMMERIDGE DR",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312202672",
            "telephone_number": "478-714-3807",
            "fax_number": "478-746-1642"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1385 OGLETHORPE ST",
            "city": "MACON",
            "state": "GA",
            "postal_code": "312011511",
            "telephone_number": "478-746-1037",
            "fax_number": "478-746-1642"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SCANDRETT",
        "first_name": "TIFFANY",
        "middle_name": "MORRIS",
        "name_prefix": "Mrs.",
        "credential": "CCC-SLP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-13",
        "last_updated": "2011-07-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "GA",
            "license": "SLP005793",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE PROVIDER ID",
            "identifier": "305467",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "167270852A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TAX IDENTIFICATION NUMBER",
            "identifier": "20-0847484",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Macon, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 20, 2011; 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.