Katie Kuberg Tucker, D.O.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

DO.2031 Issued in AL

Practice address

22136 Medical Village Drive
Athens, AL 35613

Phone

(256) 648-5598

Fax

(833) 603-1295

NPI assigned

Jun 1, 2016

Sex

Female

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in WV

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

State licenses

Practice roles

Locations

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.

• Hometown Pediatrics LLC

  • Pediatrics Physician
  • Athens, AL
  • NPI 1669091120
  NPD
• Kids 1St Pediatrics, LLC

  dba Kids First Pediatrics

  • Pediatrics Physician
  • Scottsboro, AL
  • NPI 1376090357
  NPD
• Fort Payne Pediatrics LLC

  • Rural Health Clinic/Center
  • Fort Payne, AL
  • NPI 1033477393

  Pediatrics

  NPD (past)

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

{
    "created_epoch": "1464739200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598400000000",
    "number": "1003264904",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22136 MEDICAL VILLAGE DRIVE",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "356132940",
            "telephone_number": "256-648-5598",
            "fax_number": "833-603-1295"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22136 MEDICAL VILLAGE DRIVE",
            "city": "ATHENS",
            "state": "AL",
            "postal_code": "35613",
            "telephone_number": "256-648-5598",
            "fax_number": "833-603-1295"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "800 Pennsylvania Ave",
            "address_purpose": "LOCATION",
            "city": "Charleston",
            "state": "WV",
            "postal_code": "253023351",
            "country_code": "US",
            "telephone_number": "304-414-1880",
            "fax_number": "304-414-1886",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "23800 John T Reid Pkwy",
            "address_purpose": "LOCATION",
            "city": "Scottsboro",
            "state": "AL",
            "postal_code": "35768",
            "country_code": "US",
            "telephone_number": "256-999-0808",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KATIE",
        "middle_name": "KUBERG",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-01",
        "last_updated": "2020-08-26",
        "certification_date": "2020-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "AL",
            "license": "DO.2031",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lindsay Traynom, CRNP
• Philip B Tregoning, D.M.D.
• Alyssa Tritch, DPT
• Samuel Joseph Trotter, MD
• Sarah Trotti, AU.D.
• Larry C Tucker, D.C.
• Lekiyah K Tucker, MSW
• Jocelyn Marie Turner, NP-C
• Twilight Medical Clinic, LLC
• U Save Pharmacies LLC (U-Save Pharmacy #425)

• Pediatrics Physician in Athens, AL
• Providers in Athens, AL by specialty
• Pediatrics Physician in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.