Alton Glenn Tucker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

101029876 Issued in VA

Practice address

8991 Cotswold Drive
Burke, VA 22015

Phone

(703) 440-4050

Fax

(703) 440-8246

NPI assigned

Jul 11, 2006

Last updated

Jun 13, 2012By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Loudoun Medical Group, PC

  dba Jeffrey K,. Nekoba, M.D.

  • Family Medicine Physician
  • Springfield, VA
  • NPI 1679700660
  NPD (past)
• Frederick Health Hospital Inc

  dba Frederick Health Hospital

  • General Acute Care Hospital
  • Frederick, MD
  • NPI 1538165527
  NPD (past)

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

{
    "created_epoch": "1152576000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1339545600000",
    "number": "1205861135",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8991 COTSWOLD DRIVE",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-440-4050",
            "fax_number": "703-440-8246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8991 COTSWOLD DRIVE",
            "city": "BURKE",
            "state": "VA",
            "postal_code": "22015",
            "telephone_number": "703-440-4050",
            "fax_number": "703-440-8246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ALTON",
        "middle_name": "GLENN",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-07-11",
        "last_updated": "2012-06-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "VA",
            "license": "101029876",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "005620643",
            "state": "VA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sarah Tran, LCSW
• David Michael Treff, D.D.S.
• Taylor Marie Trenner, FNP-BC
• Patrick Tubbins
• Rachel Tuchrello
• Ultimate Keepers Home Care
• Ultimate Keepers Home Care, Inc.
• Mariam Usman, FNP-BC
• Maryann Valcourt, CPNP-BC
• Waldo Oliver Valdivia, DDS

• Family Medicine Physician in Burke, VA
• Providers in Burke, VA by specialty
• Family Medicine Physician in Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 13, 2012; 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.