Mark Alan Tucker, D.O.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

R4C62 Issued in MO

Practice address

401 E Hwy 19
Center, MO 63436

Phone

(573) 267-3318

Fax

(573) 267-3933

NPI assigned

Aug 7, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in MO

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

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Interoperability endpoints

• Direct secure messaging: mtucker@hannibalclinic.directbygreenway.com

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.

• Hannibal Regional Healthcare System, Inc

  • Multi-Specialty Clinic/Center
  • Hannibal, MO
  • NPI 1134311392
  NPD (past)
• Mma Healthcare of Center, Inc.

  • Skilled Nursing Facility
  • Center, MO
  • NPI 1790829802
  NPD (past)
• Blessing Hospital

  • Emergency Medical Services (Emergency Medicine) Physician
  • Quincy, IL
  • NPI 1558489021
  NPD (past)

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

{
    "created_epoch": "1154908800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614816000000",
    "number": "1285643346",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "401 E. HWY 19",
            "city": "CENTER",
            "state": "MO",
            "postal_code": "634360311",
            "telephone_number": "573-267-3318",
            "fax_number": "573-267-3933"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 E HWY 19",
            "city": "CENTER",
            "state": "MO",
            "postal_code": "63436",
            "telephone_number": "573-267-3318",
            "fax_number": "573-267-3933"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MARK",
        "middle_name": "ALAN",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-07",
        "last_updated": "2021-03-04",
        "certification_date": "2021-03-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "R4C62",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "241722206",
            "state": "MO"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "MTucker@hannibalclinic.directbygreenway.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "401 E Hwy 19",
            "city": "Center",
            "state": "MO",
            "country_code": "US",
            "postal_code": "63436",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hannibal Regional Hospital
• Mma Healthcare of Center, Inc.
• Lisa Peterson
• Preferred Family Healthcare, Inc.
• Ralls County R-II School District
• Westview SNF Opco LLC

• Family Medicine Physician in Center, MO
• Providers in Center, MO by specialty
• Family Medicine Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 4, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.