Individual provider Active NPI

Vivica Stocker, CCC,SLP

  • Speech-Language Pathologist
  • Rock Hill, SC
National Provider Identifier
1891535472
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
8499 Issued in SC
Practice address
356 Oakland Ave
Rock Hill, SC 29730-4064
Phone
(803) 661-5033
NPI assigned
May 30, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 8499 SC Primary

Addresses

Primary practice location

356 Oakland Ave
Rock Hill, SC 29730-4064

Mailing address

958 Asheville Ave Apt 201
Fort Mill, SC 29708-0813
Phone (803) 719-1316

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
8499SCMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1717027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1891535472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "958 ASHEVILLE AVE APT 201",
            "city": "FORT MILL",
            "state": "SC",
            "postal_code": "297080813",
            "telephone_number": "803-719-1316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 OAKLAND AVE",
            "city": "ROCK HILL",
            "state": "SC",
            "postal_code": "297304064",
            "telephone_number": "803-661-5033"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STOCKER",
        "first_name": "VIVICA",
        "credential": "CCC,SLP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-05-30",
        "last_updated": "2024-05-30",
        "certification_date": "2024-05-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "SC",
            "license": "8499",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rock Hill, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 30, 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.