Independent US Healthcare Provider Directory & Public Medical Database
Active NPI 1336131994 Individual Practitioner Female Practitioner

Kimberly Jan Tucker , MED, CCC-SLP

Speech-Language Pathologist • Johns Creek, GA

Public Directory Information & Medical Disclaimer

This profile is compiled from official public domain records provided by CMS and the NPPES registry. TRUE-MEDINFO is an independent reference directory and does not provide medical advice, diagnosis, or treatment recommendations. Always consult a licensed medical professional for personal health decisions.

Professional Overview & Biography Verified Profile Summary

Kimberly Tucker, MED, CCC-SLP is a registered healthcare professional specializing in Speech-Language Pathologist in Johns Creek, GA. Official NPI practice address is registered at 10100 GROOMSBRIDGE RD.

Practice Location & Contact Primary Location

Practice Address

10100 Groomsbridge Rd

Johns Creek, GA 300222673

Telephone 7708807684

Specialty Benchmarks & Practice Insights

Comparative analytics for Speech-Language Pathologist in Johns Creek, GA

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 12.0 Yrs
State Avg: 14.3 Yrs
Regional Practice Density
19 Specialists

Practicing in Johns Creek, GA (4796 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

CMS Verified: 2022-05-06
Speech-Language Pathologist Primary Specialty

NUCC Taxonomy Code: 235Z00000X

State License GA SLP00006300

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.

Speech-Language Pathologist

NUCC Taxonomy Code: 235Z00000X

State License GA PCET001021

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.

Additional State Medicaid & Healthcare Payer Identifiers

Medicaid State Provider ID
637018452A (GA)
Medicaid State Provider ID
10033374 (GA)
Commercial Insurance / Payer ID Blue Cross & Blue Shield
52703821 002 (GA)

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

10 Historical Events
📍
Updated Practice Location May 06, 2022

Registered at 10100 GROOMSBRIDGE RD, JOHNS CREEK, GA 300222673 (Tel: 7708807684)

📍
Updated Business Mailing Address May 06, 2022

Registered at 10100 GROOMSBRIDGE RD, JOHNS CREEK, GA 300222673 (Tel: 7708807684)

👤
Provider Name / Credentials Updated May 06, 2022

Recorded as KIMBERLY TUCKER, M.ED., CCC-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) May 06, 2022

Speech-Language Pathologist (License #PCET001021 in GA)

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

📍
Updated Practice Location July 09, 2007

Registered at 3615 BRASELTON HWY, SUITE 103, DACULA, GA 300195907 (Tel: 6783779634)

📍
Updated Business Mailing Address July 09, 2007

Registered at 3615 BRASELTON HWY, SUITE 103, DACULA, GA 300195907 (Tel: 6783779634)

👤
Provider Name / Credentials Updated July 09, 2007

Recorded as KIMBERLY TUCKER, M.ED., CFY-SLP

🎓
Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Speech-Language Pathologist (License #PCET001021 in GA)

🟢
Initial NPI Registration & Enumeration August 19, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1336131994
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: August 19, 2005
Last Update: May 06, 2022
Sole Proprietor: No

Mailing Address

10100 Groomsbridge Rd

Johns Creek, GA 300222673

Phone: 7708807684

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.