Casey L Tucker, DC

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

DC 23602 Issued in CA

Practice address

1211 College Ave
Santa Rosa, CA 95404-3907

Phone

(707) 526-9355

Fax

(707) 526-9081

NPI assigned

May 18, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in CA

Enrollment records 1

Specialty

Chiropractic

Education

Life Chiropractic College - West, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Tucker Chiropractic, a Professional Corporation

  • Chiropractor
  • Santa Rosa, CA
  • NPI 1073564753
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1147910400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1346198400000",
    "number": "1083667463",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1211 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043907",
            "telephone_number": "707-526-9355",
            "fax_number": "707-526-9081"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1211 COLLEGE AVE",
            "city": "SANTA ROSA",
            "state": "CA",
            "postal_code": "954043907",
            "telephone_number": "707-526-9355",
            "fax_number": "707-526-9081"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CASEY",
        "middle_name": "L",
        "credential": "DC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-05-18",
        "last_updated": "2012-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "DC 23602",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE NUMBER",
            "identifier": "DC 23602",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brittany M Tuck
• Tucker Chiropractic, a Professional Corporation
• Reis Tucker-Meade
• Gina Tucker-Roghi, OTD, OTR/L
• Bruce Nicholson Tucker, M.D.
• Danielle Tucker
• Dawnmichelle Tucker, RN
• Laura Tucker
• Matthew Williamson Tucker, CMT
• Patty Lynn Tucker, PA

• Chiropractor in Santa Rosa, CA
• Providers in Santa Rosa, CA by specialty
• Chiropractor in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 29, 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.