Carolyn M Tucker, PHD

Primary specialty

PsychologistTaxonomy code 103T00000X

License

PY2802 Issued in FL

Practice address

1600 SW Archer Rd
Gainesville, FL 32610-0237

Phone

(352) 273-5159

Fax

(352) 273-5213

NPI assigned

Jul 17, 2006

Last updated

Oct 7, 2015By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Carolyn Maxcine Tucker Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

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

{
    "created_epoch": "1153094400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1444176000000",
    "number": "1275551715",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100237",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100237",
            "telephone_number": "352-273-5159",
            "fax_number": "352-273-5213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1600 SW ARCHER RD",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100237",
            "telephone_number": "352-273-5159",
            "fax_number": "352-273-5213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CAROLYN",
        "middle_name": "M",
        "name_prefix": "Dr.",
        "credential": "PHD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-17",
        "last_updated": "2015-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "FL",
            "license": "PY2802",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272330100",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "CAROLYN",
            "last_name": "TUCKER",
            "middle_name": "MAXCINE",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Garyel Cynthia Tubbs
• Mike Tubtim
• Amber Tucker, M.S.
• Avery Jacquelyn Tucker I
• Calvin Tucker, PHARMD
• Charles Thomas Tucker, DC
• Laurie Ann Tucker, RN LMHC
• Lyn Villanueva Tucker, PHARMD
• Mitzi Kay Tucker, ARNP
• Sandra Tucker, APRN

• Psychologist in Gainesville, FL
• Providers in Gainesville, FL by specialty
• Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2015; 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.