Jeffrey Glen Tucker, M.D.

Primary specialty

SpecialistTaxonomy code 174400000X

License

034068 Issued in GA

Practice address

980 Sanders Rd
Suite 100
Cumming, GA 30041-5977

Phone

(770) 886-1074

Fax

(770) 205-4717

NPI assigned

Sep 9, 2005

Last updated

Jan 11, 2017By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in GA

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

Specialty

General Surgery

Education

Medical College of Georgia School of Medicine, 1989

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Northside Surgical Professional Services LLCGroup PAC ID 8628253424, 367 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Northside Hospital Forsyth Hospital, Cumming, GA, CCN 110005
• Northside Hospital Hospital, Atlanta, GA, CCN 110161

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Northside Surgical Professional Services LLC

  • Surgery Physician
  • Atlanta, GA
  • NPI 1356630990
  Medicare reassignment Care Compare group NPD
• Chattahoochee Surgical Group, LLP

  • Specialist
  • Alpharetta, GA
  • NPI 1750414751
  NPD (past)
• The Vein Center of North Georgia

  • Specialist
  • Alpharetta, GA
  • NPI 1104959808
  NPD (past)

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

• Northside Hospital, Inc.

  dba Northside Hospital Forsyth

  • General Acute Care Hospital
  • Cumming, GA
  • NPI 1376574277
  Care Compare affiliation
• Northside Hospital, Inc.

  dba Northside Hospital

  • General Acute Care Hospital
  • Atlanta, GA
  • NPI 1457396079
  Care Compare affiliation

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

{
    "created_epoch": "1126224000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1484092800000",
    "number": "1265426738",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074",
            "fax_number": "770-205-4717"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 SANDERS RD",
            "address_2": "SUITE 100",
            "city": "CUMMING",
            "state": "GA",
            "postal_code": "300415977",
            "telephone_number": "770-886-1074",
            "fax_number": "770-205-4717"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JEFFREY",
        "middle_name": "GLEN",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-09-09",
        "last_updated": "2017-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "GA",
            "license": "034068",
            "primary": true
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "GA",
            "license": "034068",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000468608K",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Briley Alexandra Trugman, OTD, OTR/L
• Phuongthao Minh Truong, O.D.
• Trust Behavioral Healthcare
• Cindy Lao Tu, APRN-BC
• Arnell Ulanda Tucker, FNP-BC
• Julia Laine Tucker
• Carolyn Moshier Turner, OTR/L
• Deborah Majeres Turner, LPC
• Kathryn Turner, RN
• Tiffany Turner, RN

• Specialist in Cumming, GA
• Providers in Cumming, GA by specialty
• Specialist in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.