NPIMap

Individual provider Active NPI

Sharon Tuckett, MD

  • Internal Medicine Physician
  • Villa Rica, GA
National Provider Identifier
1285607648
Registry record updated Feb 13, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
03609 Issued in GA
Practice address
101 Quartz Dr Ste 201
Villa Rica, GA 30180
Phone
(770) 812-3839
Fax
(770) 456-3846
NPI assigned
Feb 8, 2006
Last updated
Feb 13, 2019By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 13, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X 03609 GA
Internal Medicine Physician 207R00000X 03609 GA Primary

Addresses

Primary practice location

101 Quartz Dr Ste 201
Villa Rica, GA 30180

Mailing address

119 Ambulance Dr Ste 202
Carrollton, GA 30117-3857
Phone (770) 838-8710

Other practice location 1

4720 Jonesboro Rd
Suite 11
Union City, GA 30291-1994
Phone (770) 631-6800

Other practice location 2

4720 Jonesboro Rd
Suite 11
Union City, GA 30291-1994
Phone (770) 631-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080421000143 GA Practitioner - Internal MedicinePractitioner - Hospice/Palliative Care 9436237260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal MedicineAlso: Hospice/Palliative Care
Education
JS Weill Medical College, Cornell University, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Tanner Medical Group IncGroup PAC ID 2769536143, 120 clinicians

Practice addresses (Care Compare)

101 Quartz Dr
Suite 201
Villa Rica, GA 30180-3256
Phone (770) 812-3839

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
03609GAMDHospice and Palliative Medicine (Internal Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Medical Group Inc Internal Medicine CurrentSince Mar 11, 2019 Accepting new patients
Wellstar Medical Group, LLC Internal Medicine Past Accepting new patients
Wellstar Health System, Inc. Internal Medicine Past Accepting new patients
TMC Children's Healthcare of West Georgia Past Accepting new patients
Piedmont Providers LLC Internal Medicine Past Accepting new patients
Wellstar Douglasville Medical Center, LLC Internal Medicine Past Accepting new patients

Locations

119 Ambulance Dr
Ste 202
Carrollton, GA 30117
Phone (770) 838-8710

101 Quartz Dr
Ste 201
Villa Rica, GA 30180
Phone (770) 456-3839

101 Quartz Dr
Ste 203
Villa Rica, GA 30180
Phone (770) 812-3631

690 Dallas Hwy
Ste 207A
Villa Rica, GA 30180
Phone (770) 456-3646

Organizations & group practices 6

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.

Hospital & facility affiliations 11

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": "1139356800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1550016000000",
    "number": "1285607648",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 AMBULANCE DR STE 202",
            "city": "CARROLLTON",
            "state": "GA",
            "postal_code": "301173857",
            "telephone_number": "770-838-8710",
            "fax_number": "770-838-8563"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 QUARTZ DR STE 201",
            "city": "VILLA RICA",
            "state": "GA",
            "postal_code": "30180",
            "telephone_number": "770-812-3839",
            "fax_number": "770-456-3846"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4720 Jonesboro Rd",
            "address_2": "Suite 11",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "GA",
            "postal_code": "302911994",
            "country_code": "US",
            "telephone_number": "770-631-6800",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "4720 Jonesboro Rd",
            "address_2": "Suite 11",
            "address_purpose": "LOCATION",
            "city": "Union City",
            "state": "GA",
            "postal_code": "302911994",
            "country_code": "US",
            "telephone_number": "770-631-6800",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKETT",
        "first_name": "SHARON",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-02-08",
        "last_updated": "2019-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": "GA",
            "license": "03609",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "03609",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Villa Rica, GA

Sources for this page

Verify at the official NPI Registry.