Active NPI
Julie Tuck
- Pedorthist
- Nashville, AR
National Provider Identifier
1043561855
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pedorthist
- License
- CPED3851
- Practice address
- 24 Southpark Shopping Ctr
Nashville, AR 71852-3307 - Phone
- (870) 845-3813
- Fax
- (870) 845-3808
- NPI assigned
- Sep 20, 2012
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pedorthist | 224L00000X | CPED3851 | AR | Primary |
Addresses
Primary practice location
24 Southpark Shopping Ctr
Nashville, AR 71852-3307
Mailing address
24 Southpark Shopping Ctr
Nashville, AR 71852-3307
Phone (870) 845-3813
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CPED3851 | Other | AR | CERTIFIED PEDORTHIST |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| CPED3851 | AR | MD | Pedorthist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Select Medical Supplies of Arkansas, Inc. | Past | Accepting new patients |
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.
-
- Durable Medical Equipment & Medical Supplies
- Nashville, AR
- NPI 1982911798
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1348099200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1348099200000",
"number": "1043561855",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "24 SOUTHPARK SHOPPING CTR",
"city": "NASHVILLE",
"state": "AR",
"postal_code": "718523307",
"telephone_number": "870-845-3813",
"fax_number": "870-845-3808"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "24 SOUTHPARK SHOPPING CTR",
"city": "NASHVILLE",
"state": "AR",
"postal_code": "718523307",
"telephone_number": "870-845-3813",
"fax_number": "870-845-3808"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCK",
"first_name": "JULIE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2012-09-20",
"last_updated": "2012-09-20",
"status": "A"
},
"taxonomies": [
{
"code": "224L00000X",
"taxonomy_group": "",
"desc": "Pedorthist",
"state": "AR",
"license": "CPED3851",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CERTIFIED PEDORTHIST",
"identifier": "CPED3851",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Nashville, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 20, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.