Individual provider Active NPI

Audrey Elizabeth Tucker

  • Speech-Language Pathologist
  • West Des Moines, IA
National Provider Identifier
1952187833
Registry record updated Sep 6, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
122244 Issued in TN
Practice address
105 Valley West Dr
West Des Moines, IA 50265-3902
Phone
(515) 223-4368
Fax
(515) 453-2368
NPI assigned
Sep 6, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 6, 2023

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 122244 TN Primary

Addresses

Primary practice location

105 Valley West Dr
West Des Moines, IA 50265-3902

Mailing address

105 Valley West Dr
West Des Moines, IA 50265-3902

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230922000911 IA Practitioner - Qualified Speech Language Pathologist 5092169268

Care Compare profile

Medicare Care Compare
Specialty
Qualified Speech Language Pathologist
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Iowa ENT Center PLLCGroup PAC ID 6406007608, 13 clinicians

Practice addresses (Care Compare)

105 Valley W Dr
Suite 100
West Des Moines, IA 50265-3902
Phone (515) 223-4368

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
122244TNMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Iowa ENT Center PLLC CurrentSince Sep 11, 2023 Accepting new patients

Locations

405 Monroe St
Ste A
Pella, IA 50219
Phone (641) 628-2837

105 Valley West Dr
Ste 100
West Des Moines, IA 50265
Phone (515) 223-4368

105 Valley West Dr
West Des Moines, IA 50265
Phone (515) 223-4368

300 W Hutchings St
Winterset, IA 50273
Phone (515) 223-4368

Organizations & group practices 1

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": "1693958400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693958400000",
    "number": "1952187833",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "105 VALLEY WEST DR",
            "city": "WEST DES MOINES",
            "state": "IA",
            "postal_code": "502653902",
            "telephone_number": "515-223-4368",
            "fax_number": "515-453-2368"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "AUDREY",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-06",
        "last_updated": "2023-09-06",
        "certification_date": "2023-09-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "TN",
            "license": "122244",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Des Moines, IA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.