Mackenzie Ann Stucker, TC.A.D.C.

Primary specialty

Substance Abuse Rehabilitation FacilityTaxonomy code 324500000X

Practice address

2030 Keokuk St
Iowa City, IA 52240-4456

Phone

(319) 351-9760

Fax

(319) 351-9760

NPI assigned

Feb 2, 2018

Last updated

Feb 2, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Awakening Substance Abuse & Behavioral Health

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Iowa City, IA
  • NPI 1164032934
  NPD (past)

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

{
    "created_epoch": "1517529600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1517529600000",
    "number": "1003315276",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2030 KEOKUK ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2030 KEOKUK ST",
            "city": "IOWA CITY",
            "state": "IA",
            "postal_code": "522404456",
            "telephone_number": "319-351-9760",
            "fax_number": "319-351-9760"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "STUCKER",
        "first_name": "MACKENZIE",
        "middle_name": "ANN",
        "credential": "TC.A.D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-02",
        "last_updated": "2018-02-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "324500000X",
            "taxonomy_group": "",
            "desc": "Substance Abuse Rehabilitation Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Roger Daniel Struble Jr., MD, MPH
• Bryan D Struck, MD
• Robert Allen Strug, DDS
• Ann Riesselman Struve, ARNP
• Unni B Stuart, PA-C
• Lonnie Lee Stuckey II
• Kelsey Ann Stueland, ARNP
• Laura Stulken, PA-C
• Timothy Dale Stultz, BS
• Krista Stumme, MD

• Substance Abuse Rehabilitation Facility in Iowa City, IA
• Providers in Iowa City, IA by specialty
• Substance Abuse Rehabilitation Facility in Iowa

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.