Tucker Keith Forbes, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

AT003037 Issued in GA

Practice address

1275 Highway 54 W Ste 200
Fayetteville, GA 30214-4538

Phone

(770) 460-8609

Fax

(770) 460-8629

NPI assigned

Jan 8, 2019

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1546905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1546905600000",
    "number": "1215400734",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6397 LEE HWY STE 300",
            "city": "CHATTANOOGA",
            "state": "TN",
            "postal_code": "374214915",
            "telephone_number": "423-238-7217",
            "fax_number": "423-238-3473"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1275 HIGHWAY 54 W STE 200",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302144538",
            "telephone_number": "770-460-8609",
            "fax_number": "770-460-8629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORBES",
        "first_name": "TUCKER",
        "middle_name": "KEITH",
        "credential": "ATC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-01-08",
        "last_updated": "2019-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "GA",
            "license": "AT003037",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amanda Lee Floyd, LAPC
• Janine Foerster, D.C.
• Tara Austin Fogle, D.M.D.
• Foglim Hospice LLC
• Connie Forbes, LMT
• Arish Ford
• Fianna Ford, PA-C
• Paula Michelle Forrester, M.ED
• Shaw Wendi Fortuchang, M.D.
• Elizabeth K Foster, M.ED, BCBA

• Athletic Trainer in Fayetteville, GA
• Providers in Fayetteville, GA by specialty
• Athletic Trainer in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2019; 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.