Active NPI
Abigail D Tucker, SLP
- Speech-Language Pathologist
- Stone Mountain, GA
National Provider Identifier
1912557489
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Speech-Language Pathologist
- License
- 1561
- Practice address
- 1218 Rockbridge Rd
Stone Mountain, GA 30087-3013 - Phone
- (470) 545-6228
- NPI assigned
- Sep 17, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Speech-Language Pathologist | 235Z00000X | 1561 | GA | Primary |
Addresses
Primary practice location
1218 Rockbridge Rd
Stone Mountain, GA 30087-3013
Mailing address
2705 McClave Dr
Atlanta, GA 30340-1934
Phone (770) 936-0728
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
| License | State | Type | Specialty |
|---|---|---|---|
| 1561 | GA | MD | Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1568678400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1568678400000",
"number": "1912557489",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2705 MCCLAVE DR",
"city": "ATLANTA",
"state": "GA",
"postal_code": "303401934",
"telephone_number": "770-936-0728"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1218 ROCKBRIDGE RD",
"city": "STONE MOUNTAIN",
"state": "GA",
"postal_code": "300873013",
"telephone_number": "470-545-6228"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "ABIGAIL",
"middle_name": "D",
"credential": "SLP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-09-17",
"last_updated": "2019-09-17",
"status": "A"
},
"taxonomies": [
{
"code": "235Z00000X",
"taxonomy_group": "",
"desc": "Speech-Language Pathologist",
"state": "GA",
"license": "1561",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Stone Mountain, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.