Individual provider Active NPI

David Cushing Tucker Jr., OTR/L

  • Occupational Therapist
  • Raleigh, NC
National Provider Identifier
1306279336
Registry record updated Aug 13, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
8702 Issued in NC
Practice address
11200 Governor Manly Way
Raleigh, NC 27614
Phone
(919) 562-9410
NPI assigned
Aug 13, 2013
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 13, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 8702 NC Primary

Addresses

Primary practice location

11200 Governor Manly Way
Raleigh, NC 27614

Mailing address

13605 Old Creedmoor Rd
Wake Forest, NC 27587
Phone (919) 264-3391

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20140305001607 NC Practitioner - Occupational Therapist in Private Practice 8527298868 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Duke University Health System, IncGroup PAC ID 2567372345, 1,083 clinicians

Practice addresses (Care Compare)

1545 Orchard Villas Ave
Apex, NC 27502-4338
Phone (919) 954-4492

2301 Erwin Rd
Durham, NC 27705-4699
Phone (919) 684-8111

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8702NCMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
Duke University Health System, Inc. CurrentSince Oct 9, 2019 Accepting new patients
Duke University Health System, Inc. CurrentSince Oct 9, 2019 Accepting new patients

Locations

2301 Erwin Rd
Durham, NC 27705
Phone (919) 668-0289

3609 Southwest Durham Dr
Durham, NC 27707
Phone (919) 471-9622

3643 N Roxboro St
Durham, NC 27704
Phone (919) 470-6186

40 Duke Medicine Cir
Durham, NC 27710
Phone (919) 681-6588

5213 S Alston Ave
Durham, NC 27713
Phone (919) 620-4700

162 Legacy Oaks Dr
Ste 2102
Knightdale, NC 27545
Phone (919) 373-1799

5920 Sandy Forks Rd
Ste 200
Raleigh, NC 27609
Phone (919) 954-3174

3000 Rogers Rd
Wake Forest, NC 27587
Phone (919) 385-1080

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.

NPI Registry JSON

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

{
    "created_epoch": "1376352000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1376352000000",
    "number": "1306279336",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "13605 OLD CREEDMOOR RD",
            "city": "WAKE FOREST",
            "state": "NC",
            "postal_code": "27587",
            "telephone_number": "919-264-3391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11200 GOVERNOR MANLY WAY",
            "city": "RALEIGH",
            "state": "NC",
            "postal_code": "27614",
            "telephone_number": "919-562-9410"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DAVID",
        "middle_name": "CUSHING",
        "name_prefix": "Mr.",
        "name_suffix": "Jr.",
        "credential": "OTR/L",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-08-13",
        "last_updated": "2013-08-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NC",
            "license": "8702",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Raleigh, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 13, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.