Individual provider Active NPI

Gary-Christian Ryan Herwig-Tucker

  • Technician
  • Flint, MI
National Provider Identifier
1063169258
Registry record updated Mar 7, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
TechnicianTaxonomy code 374700000X
Practice address
504 N Grand Traverse St
Flint, MI 48503-2536
Phone
(810) 487-4295
NPI assigned
Mar 7, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 7, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Technician 374700000X Primary

Addresses

Primary practice location

504 N Grand Traverse St
Flint, MI 48503-2536

Mailing address

1220 Vincent CT
Flint, MI 48503-1280
Phone (810) 986-0786

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

NPI Registry JSON

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

{
    "created_epoch": "1646611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1646611200000",
    "number": "1063169258",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1220 VINCENT CT",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485031280",
            "telephone_number": "810-986-0786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "504 N GRAND TRAVERSE ST",
            "city": "FLINT",
            "state": "MI",
            "postal_code": "485032536",
            "telephone_number": "810-487-4295"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HERWIG-TUCKER",
        "first_name": "GARY-CHRISTIAN",
        "middle_name": "RYAN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-07",
        "last_updated": "2022-03-07",
        "certification_date": "2022-03-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374700000X",
            "taxonomy_group": "",
            "desc": "Technician",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Flint, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2022; 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.