Mallory Keck Tucker, PHARMD

Primary specialty

PharmacistTaxonomy code 183500000X

License

43318 Issued in TN

Practice address

102 E Broadway
Newport, TN 37821-2323

Phone

(423) 623-0364

NPI assigned

Aug 24, 2020

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Doctor of Pharmacy

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.

• Walgreen Co

  • Pharmacy
  • Newport, TN
  • NPI 1629103916
  NPD
• Walgreen Co

  • Pharmacy
  • Longview, TX
  • NPI 1629956545
  NPD (past)

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

{
    "created_epoch": "1598227200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1598227200000",
    "number": "1023621794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "102 E BROADWAY",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378212323",
            "telephone_number": "423-623-0364"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "102 E BROADWAY",
            "city": "NEWPORT",
            "state": "TN",
            "postal_code": "378212323",
            "telephone_number": "423-623-0364"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MALLORY",
        "middle_name": "KECK",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-08-24",
        "last_updated": "2020-08-24",
        "certification_date": "2020-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TN",
            "license": "43318",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TENNESSEE BOARD OF PHARMACY",
            "identifier": "43318",
            "state": "TN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "rxm.10688@store.walgreens.com",
            "affiliation": "N",
            "address_1": "102 E Broadway",
            "city": "Newport",
            "state": "TN",
            "country_code": "US",
            "postal_code": "378212323",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Kim M Thomas, APN
• Abigail Thompson
• Town & Country Drugs
• Lincoln Forrest Trent
• David Neal Troutman, DDS
• Elizabeth Ann Uhls, BSW
• Lindsay Tyler Vaughn, RN
• Jarrod Vick, PHARM.D.
• Aleksandr Vinogradov, DPM
• Vip Physical Therapy, LLC

• Pharmacist in Newport, TN
• Providers in Newport, TN by specialty
• Pharmacist in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2020; 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.