Individual provider Active NPI

Dave Wayne Tuck, D.C.

  • Sports Physician Chiropractor
  • Louisville, CO
National Provider Identifier
1003850264
Registry record updated Sep 10, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physician ChiropractorTaxonomy code 111NS0005X
License
6262 Issued in TX
Practice address
333 W South Boulder Rd Ste 4
Louisville, CO 80027-1674
Phone
(720) 457-9509
Fax
(903) 564-7981
NPI assigned
Jun 16, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 10, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physician Chiropractor 111NS0005X 6262 TX Primary

Addresses

Primary practice location

333 W South Boulder Rd Ste 4
Louisville, CO 80027-1674

Mailing address

333 W South Boulder Rd
Louisville, CO 80027-1673
Phone (720) 457-9509

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
6262TXMDSports Physician Chiropractor
8642COMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Duke City Urgent Care PastSince Sep 15, 2024 Accepting new patients

Networks

  • TX HMO
  • TX HMO D-SNP
  • NM HMO C-SNP

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/27050/brand/1/csg/1/fhir/r4

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": "1150416000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1003850264",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "333 W SOUTH BOULDER RD",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271673",
            "telephone_number": "720-457-9509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 W SOUTH BOULDER RD STE 4",
            "city": "LOUISVILLE",
            "state": "CO",
            "postal_code": "800271674",
            "telephone_number": "720-457-9509",
            "fax_number": "903-564-7981"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "DAVE",
        "middle_name": "WAYNE",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-16",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NS0005X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Sports Physician",
            "state": "TX",
            "license": "6262",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisville, CO

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; 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.