Individual provider Active NPI

Domeka Hubert Tucker, CNA

  • Home Health Aide
  • Lithia Springs, GA
National Provider Identifier
1205524758
Registry record updated Apr 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AideTaxonomy code 374U00000X
License
CN0030082643 Issued in GA
Practice address
3320 Beulah Ridge CT
Lithia Springs, GA 30122-2101
Phone
(678) 439-4362
NPI assigned
Apr 24, 2023
Last updated
Apr 24, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Aide 374U00000X CN0030082643 GA Primary

Addresses

Primary practice location

3320 Beulah Ridge CT
Lithia Springs, GA 30122-2101

Mailing address

3320 Beulah Ridge CT
Lithia Springs, GA 30122-2101
Phone (678) 439-4362

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CN0030082643GAMDHome Health Aide

Practice roles

OrganizationSpecialtyStatusNew patients
Prayers Answered LLC CurrentSince Oct 1, 2023 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, 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": "1682294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1205524758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3320 BEULAH RIDGE CT",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222101",
            "telephone_number": "678-439-4362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3320 BEULAH RIDGE CT",
            "city": "LITHIA SPRINGS",
            "state": "GA",
            "postal_code": "301222101",
            "telephone_number": "678-439-4362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUBERT TUCKER",
        "first_name": "DOMEKA",
        "credential": "CNA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-04-24",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374U00000X",
            "taxonomy_group": "",
            "desc": "Home Health Aide",
            "state": "GA",
            "license": "CN0030082643",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lithia Springs, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 2023; 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.