NPIMap

Individual provider Active NPI

Joshua Thomas Tucker, PA-C

  • Physician Assistant
  • Greenville, SC
National Provider Identifier
1194278127
Registry record updated Sep 27, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
2580 Issued in SC
Practice address
3909 S Highway 14
Greenville, SC 29615-6138
Phone
(864) 522-1320
Fax
(864) 522-1325
NPI assigned
Jul 26, 2016
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 2580 SC Primary

Addresses

Primary practice location

3909 S Highway 14
Greenville, SC 29615-6138

Mailing address

1 Independence PT
Suite 212
Greenville, SC 29615-4545
Phone (864) 797-6044

Other identifiers 1

IdentifierTypeStateIssuer
2697PAMedicaidSC

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20160907000401 SC Practitioner - Physician Assistant 2365738077 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

210 Freeman Farm Rd
Duncan, SC 29334-9398
Phone (864) 968-5123

300 E McBee Ave
Greenville, SC 29601-2842
Phone (864) 797-6220

300 E McBee Ave FL
Suite 4
Greenville, SC 29601-2842

3907 S Hwy 14
Greenville, SC 29615-6138
Phone (864) 522-1300

3909 S Hwy 14
Greenville, SC 29615-6138
Phone (864) 627-8878

3911 S Hwy 14
Greenville, SC 29615-6138
Phone (864) 522-1340

3917 S Hwy 14
Greenville, SC 29615-6138
Phone (864) 522-1360

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
2580SCMDAdvanced Practice Midwife

Practice roles

OrganizationSpecialtyStatusNew patients
Prisma Health University Medical Group CurrentSince Jul 18, 2016 Accepting new patients
Prisma Health University Medical Group Past Accepting new patients

Locations

22725 US Highway 76
Clinton, SC 29325
Phone (864) 833-9100

210 Freeman Farm Rd
Duncan, SC 29334
Phone (864) 968-5123

2A Cleveland Ct
Greenville, SC 29607
Phone (864) 271-7761

701 Grove Rd
Greenville, SC 29605
Phone (864) 454-2030

3909 S Highway 14
Greenville, SC 29615
Phone (864) 522-1320

175 Patewood Dr
Greenville, SC 29615
Phone (864) 797-1000

3907 S Highway 14
Greenville, SC 29615
Phone (864) 234-0226

830 S Buncombe Rd
Greer, SC 29650
Phone (864) 797-8000

298 Memorial Dr
Seneca, SC 29672
Phone (864) 482-3100

1413 John B White SR Blvd
Ste D
Spartanburg, SC 29306
Phone (864) 587-5768

Interoperability endpoints

  • Direct secure messaging: jtucker126828@direct.ghs.myhfn.org

Organizations & group practices 2

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.

Hospital & facility affiliations 52

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 52

NPI Registry JSON

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

{
    "created_epoch": "1469491200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1474934400000",
    "number": "1194278127",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1 INDEPENDENCE PT",
            "address_2": "SUITE 212",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296154545",
            "telephone_number": "864-797-6044"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3909 S HIGHWAY 14",
            "city": "GREENVILLE",
            "state": "SC",
            "postal_code": "296156138",
            "telephone_number": "864-522-1320",
            "fax_number": "864-522-1325"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JOSHUA",
        "middle_name": "THOMAS",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-07-26",
        "last_updated": "2016-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "SC",
            "license": "2580",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2697PA",
            "state": "SC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Greenville, SC

Sources for this page

Verify at the official NPI Registry.