Individual provider Active NPI

Shamekia Tucker

  • Adult Health Nurse Practitioner
  • West Columbia, SC
National Provider Identifier
1073978672
Registry record updated Jan 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Adult Health Nurse PractitionerTaxonomy code 363LA2200X
License
RN214341 Issued in GA
Practice address
2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815
Phone
(803) 744-4900
Fax
(770) 502-2056
NPI assigned
Dec 24, 2015
Last updated
Jan 19, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Adult Health Nurse Practitioner 363LA2200X RN214341 GA Primary

Addresses

Primary practice location

2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815

Mailing address

2728 Sunset Blvd Ste 300
West Columbia, SC 29169-4815
Phone (203) 744-4900

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address stucker153721@direct.lexmed.com
Direct Messaging Address stucker153721@direct.lexmed.com

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
Credentials
Nurse Practitioner

NPI Registry JSON

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

{
    "created_epoch": "1450915200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1705622400000",
    "number": "1073978672",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 300",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694815",
            "telephone_number": "203-744-4900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2728 SUNSET BLVD STE 300",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694815",
            "telephone_number": "803-744-4900",
            "fax_number": "770-502-2056"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SHAMEKIA",
        "name_prefix": "Ms.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-12-24",
        "last_updated": "2024-01-19",
        "certification_date": "2024-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "GA",
            "license": "RN214341",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stucker153721@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stucker153721@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2728 Sunset Blvd Ste 300",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694815",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in West Columbia, SC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 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.