Jackson Seth Tucker, AA

Primary specialty

Anesthesiologist AssistantTaxonomy code 367H00000X

License

00123 Issued in GA

Practice address

915 Gordon Ave
Thomasville, GA 31792-6614

Phone

(800) 232-5703

NPI assigned

Aug 21, 2012

Last updated

Aug 21, 2012By the provider in NPPES

Sex

Male

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 GA

Enrollment records 1

Specialty

Anesthesiology Assistant

Education

Other, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

South Georgia Anesthesia Associates, PCGroup PAC ID 1759349830, 28 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Archbold Memorial Hospital Hospital, Thomasville, GA, CCN 110038

Medicare enrollment (NPD)

Enrolled

Credentials

Associate of Arts

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• South Georgia Anesthesia Associates, PC

  • Pain Medicine (Anesthesiology) Physician
  • Thomasville, GA
  • NPI 1285605733

  Anesthesiologist Assistant

  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• John D Archbold Memorial Hospital Inc

  dba Archbold Memorial

  • General Acute Care Hospital
  • Thomasville, GA
  • NPI 1194779702
  Care Compare affiliation
• John D. Archbold Memorial Hospital, Inc.

  dba John D. Archbold Memorial Hospital - Rehab

  • Rehabilitation Hospital Unit
  • Thomasville, GA
  • NPI 1104867738
  Care Compare affiliation

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

{
    "created_epoch": "1345507200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1345507200000",
    "number": "1053669119",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2125",
            "city": "COLUMBUS",
            "state": "GA",
            "postal_code": "319022125",
            "telephone_number": "800-232-5703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "915 GORDON AVE",
            "city": "THOMASVILLE",
            "state": "GA",
            "postal_code": "317926614",
            "telephone_number": "800-232-5703"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JACKSON",
        "middle_name": "SETH",
        "credential": "AA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-08-21",
        "last_updated": "2012-08-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367H00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiologist Assistant",
            "state": "GA",
            "license": "00123",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Philip D Troyer, M.D.
• Christian Trujillo, MD
• Trumarx Drugs Inc
• Truth Is Therapy & More, LLC (Shakilah Williams)
• Madison Nicole Tuch, LMSW
• Kate Courtney Tucker, PA
• Lisa B. Tudor, LD
• Regina Renell Turner, APRN
• Wendy Turney, LCSW
• Gregory Turnmire, DPT

• Anesthesiologist Assistant in Thomasville, GA
• Providers in Thomasville, GA by specialty
• Anesthesiologist Assistant in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 21, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.