Individual provider Active NPI

Victoria Tucker, N.P.

  • Pediatric Nurse Practitioner
  • Wilmington, NC
National Provider Identifier
1164633988
Registry record updated Aug 13, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
005001023 Issued in NC
Practice address
2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone
(910) 763-2072
Fax
(910) 763-1586
NPI assigned
May 24, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nurse Practitioner 363LP0200X 005001023 NC Primary

Addresses

Primary practice location

2421 Silver Stream LN
Wilmington, NC 28401-7684

Mailing address

2421 Silver Stream LN
Wilmington, NC 28401-7684
Phone (910) 763-2072

Other names 1

  • Victoria Mannion Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20051221000662 NC Practitioner - Nurse Practitioner 4183646946 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
005001023NCMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Wilmington Health PLLC Current Accepting new patients
Wilmington Health PLLC CurrentSince Apr 16, 2013 Accepting new patients
Wilmington ASC LLC CurrentSince Apr 16, 2013 Accepting new patients

Locations

1300 Bridge Barrier Rd
Ste 2
Carolina Beach, NC 28428
Phone (910) 458-4101

1333 S Dickinson Dr
Leland, NC 28451
Phone (910) 332-0241

8108 Market St
#B
Wilmington, NC 28411
Phone (910) 686-2099

4320 Henson Dr
Wilmington, NC 28405
Phone (910) 763-2072

2421 Silver Stream Ln
Wilmington, NC 28401
Phone (910) 763-2072

2511 Delaney Ave
Wilmington, NC 28403
Phone (910) 667-9328

1202 Medical Center Dr
Wilmington, NC 28401
Phone (910) 617-6705

1920 S 16th St
Wilmington, NC 28401
Phone (910) 632-2191

Interoperability endpoints

  • Direct secure messaging: victoria.tucker.p1@direct.wilmingtonhealth.nextgenshare.com

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1179964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1407888000000",
    "number": "1164633988",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2421 SILVER STREAM LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017684",
            "telephone_number": "910-763-2072",
            "fax_number": "910-763-1586"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2421 SILVER STREAM LN",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284017684",
            "telephone_number": "910-763-2072",
            "fax_number": "910-763-1586"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "VICTORIA",
        "credential": "N.P.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-05-24",
        "last_updated": "2014-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NC",
            "license": "005001023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "VICTORIA",
            "last_name": "MANNION",
            "credential": "N.P.",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.