Myranda Tuck

Primary specialty

Speech-Language PathologistTaxonomy code 235Z00000X

License

30002706 Issued in NC

Practice address

1466 Main Street
Yanceyville, NC 27379

Phone

(919) 323-8480

NPI assigned

May 15, 2019

Last updated

Dec 12, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Autism Society of North Carolina, Inc.

  • Community/Behavioral Health Agency
  • Raleigh, NC
  • NPI 1881751865
  NPD (past)

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

{
    "created_epoch": "1557878400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733961600000",
    "number": "1841856861",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1466 MAIN STREET",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "27379",
            "telephone_number": "919-323-8480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1466 MAIN STREET",
            "city": "YANCEYVILLE",
            "state": "NC",
            "postal_code": "27379",
            "telephone_number": "919-323-8480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "MYRANDA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-05-15",
        "last_updated": "2024-12-12",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "NC",
            "license": "30002706",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tamela Blackwell (Dogwood Forest Family Care Home Two)
• Danielle Leigh Taylor, DMD
• The Lifespan Center
• Anya Tilly, OTR/L
• Trinity Behavioral Healthcare PC
• Two Rivers Physician Practices, LLC
• Jill Elaine Van Horn, DO
• Antonia Vincent, LCSW
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-3036)
• Anna Elizabeth Whited, NCMHCA

• Speech-Language Pathologist in Yanceyville, NC
• Providers in Yanceyville, NC by specialty
• Speech-Language Pathologist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2024; 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.