Madison Tacker, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

L058032 Issued in AR

Practice address

3000 Goffs Falls Rd Ste 101
Manchester, NH 03103-6109

Phone

(800) 995-2673

Fax

(800) 995-2673

NPI assigned

Nov 27, 2017

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Madison McClain Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1511740800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1511740800000",
    "number": "1124532379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3000 GOFFS FALLS RD STE 101",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036109",
            "telephone_number": "800-995-2673"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3000 GOFFS FALLS RD STE 101",
            "city": "MANCHESTER",
            "state": "NH",
            "postal_code": "031036109",
            "telephone_number": "800-995-2673",
            "fax_number": "800-995-2673"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKER",
        "first_name": "MADISON",
        "credential": "LPN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2017-11-27",
        "last_updated": "2017-11-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "VT",
            "license": "025.0133125",
            "primary": false
        },
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "AR",
            "license": "L058032",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MADISON",
            "last_name": "MCCLAIN",
            "credential": "LPN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kristen M Symansky, DO
• Chelsea L Szepan, APRN
• Rita C. Szeto, RPH
• Andrea Szirbik, BA
• Grace Tabat
• Senait B. Taffere, PA-C
• Mohamed Habib Ahmed Taha, DDS
• Toki Tahara, DPT
• Farah Tahir, PHYSICIAN ASSISTANT
• Elizabeth Ann Talbot

• Licensed Practical Nurse in Manchester, NH
• Providers in Manchester, NH by specialty
• Licensed Practical Nurse in New Hampshire

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2017; 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.