Individual provider Active NPI

Dyas T. Tucker Sr., D.C.

  • Chiropractor
  • Atlanta, GA
National Provider Identifier
1164598488
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
007074 Issued in GA
Practice address
3050 Martin Luther King Jr Dr SW Ste J4
Atlanta, GA 30311-1500
Phone
(404) 691-8881
Fax
(404) 691-8999
NPI assigned
Nov 28, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 007074 GA Primary

Addresses

Primary practice location

3050 Martin Luther King Jr Dr SW Ste J4
Atlanta, GA 30311-1500

Mailing address

3252 Hidden Valley Pointe SW
Marietta, GA 30008-7699
Phone (770) 438-8466

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

Practice roles

OrganizationSpecialtyStatusNew patients
Jamanda Healthcare Services PC Chiropractor PastSince Dec 27, 2003 Accepting new patients

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1164672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1164598488",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3252 HIDDEN VALLEY POINTE SW",
            "city": "MARIETTA",
            "state": "GA",
            "postal_code": "300087699",
            "telephone_number": "770-438-8466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3050 MARTIN LUTHER KING JR DR SW STE J4",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303111500",
            "telephone_number": "404-691-8881",
            "fax_number": "404-691-8999"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DYAS",
        "middle_name": "T.",
        "name_prefix": "Dr.",
        "name_suffix": "Sr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-28",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "GA",
            "license": "007074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.