Individual provider Active NPI

Kindrell S Tucker, M.D.

  • Family Medicine Physician
  • Lufkin, TX
National Provider Identifier
1245586296
Registry record updated Oct 2, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
Q3822 Issued in TX
Practice address
305 Shands Dr
Lufkin, TX 75904-2885
Phone
(936) 225-3657
Fax
(936) 899-7293
NPI assigned
Jul 27, 2012
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 2, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Q3822 TX Primary

Addresses

Primary practice location

305 Shands Dr
Lufkin, TX 75904-2885

Mailing address

PO Box 154137
Lufkin, TX 75915-4137
Phone (936) 225-3657

Other identifiers 2

IdentifierTypeStateIssuer
1245586296OtherTYPE I NATIONAL PROVIDER IDENTIFIER
1467988600OtherTYPE II NATIONAL PROVIDER IDENTIFIER

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150629000149 TX Practitioner - Family Practice 1254651466 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Texas Medical School at Houston, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Kindrell S Tucker MD PAGroup PAC ID 4587936125, 2 clinicians

Practice addresses (Care Compare)

305 Shands Dr
Lufkin, TX 75904-2885
Phone (936) 225-3657

Hospital & facility affiliations

  • Woodland Heights Medical Center Hospital, Lufkin, TX, CCN 450484
  • CHI St Lukes Health Memorial Lufkin Hospital, Lufkin, TX, CCN 450211

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Kindrell S. Tucker, MD, PA Family Medicine CurrentSince Jun 1, 2017 Accepting new patients
Lufkin Physician Services PA CurrentSince Mar 18, 2017 Accepting new patients

Locations

1320 S John Redditt Dr
Ste B
Lufkin, TX 75904
Phone (936) 225-3657

505 S John Redditt Dr
Lufkin, TX 75904
Phone (713) 512-1200

305 Shands Dr
Lufkin, TX 75904
Phone (936) 225-3657

Interoperability endpoints

  • Direct secure messaging: kindrell.tucker.1@16092.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/16092/brand/3/csg/1/fhir/r4

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 2

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

NPI Registry JSON

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

{
    "created_epoch": "1343347200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1759363200000",
    "number": "1245586296",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 154137",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759154137",
            "telephone_number": "936-225-3657",
            "fax_number": "936-899-7293"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 SHANDS DR",
            "city": "LUFKIN",
            "state": "TX",
            "postal_code": "759042885",
            "telephone_number": "936-225-3657",
            "fax_number": "936-899-7293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KINDRELL",
        "middle_name": "S",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-07-27",
        "last_updated": "2025-10-02",
        "certification_date": "2025-10-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "TX",
            "license": "Q3822",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE I NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1245586296",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "TYPE II NATIONAL PROVIDER IDENTIFIER",
            "identifier": "1467988600",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lufkin, TX

Sources for this page

Verify at the official NPI Registry.