KIMBERLY JAN TUCKER M.ED. CCC-SLP NPI 1336131994

NPI Information

  • NPI: 1336131994
  • Provider Name: KIMBERLY JAN TUCKER, M.ED., CCC-SLP
  • Classification: Speech-Language Pathologist - 235Z00000X
  • Entity Type: Individual
  • Address: 10100 GROOMSBRIDGE RD
    JOHNS CREEK, GA
    ZIP 30022
  • Phone: (770) 880-7684

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NPI Details

Kimberly Jan Tucker, M.ED., CCC-SLP is a speech language pathologist in Johns Creek, GA. The provider is the speech-language pathologist is the professional who engages in clinical services, prevention, advocacy, education, administration, and research in the areas of communication and swallowing across the life span from infancy through geriatrics. Speech-language pathologists address typical and atypical impairments and disorders related to communication and swallowing in the areas of speech sound production, resonance, voice, fluency, language (comprehension and expression), cognition, and feeding and swallowing. Kimberly Jan Tucker, M.ED., CCC-SLP NPI is 1336131994. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

10100 GROOMSBRIDGE RD
JOHNS CREEK, GA
ZIP 30022-673
Phone: (770) 880-7684

The enumeration date for this NPI number is 8/19/2005 and was last updated on 5/6/2022.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1235Z00000XSpeech-Language PathologistPCET001021GEORGIANo
2235Z00000XSpeech-Language PathologistSLP00006300GEORGIAYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No. Other Provider Identifier Other Provider Identifier Type Other Provider Identifier State Other Provider Identifier Issuer
110033374MEDICAIDGEORGIA
252703821 002OTHERGEORGIABLUE CROSS & BLUE SHIELD
3637018452AMEDICAIDGEORGIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 3/30/2025

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