Kristin Sharp Tucker

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

RN195188 Issued in GA

Practice address

604 E Park Ave
Valdosta, GA 31602-3060

Phone

(229) 333-0277

Fax

(229) 241-1608

NPI assigned

Apr 23, 2019

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

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: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Interoperability endpoints

• Direct secure messaging: ms_ktucke42@landmarkhealth-direct.org

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

{
    "created_epoch": "1555977600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1579651200000",
    "number": "1306400601",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316023060",
            "telephone_number": "229-333-0277",
            "fax_number": "229-241-1608"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "604 E PARK AVE",
            "city": "VALDOSTA",
            "state": "GA",
            "postal_code": "316023060",
            "telephone_number": "229-333-0277",
            "fax_number": "229-241-1608"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KRISTIN",
        "middle_name": "SHARP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-23",
        "last_updated": "2020-01-22",
        "certification_date": "2020-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "GA",
            "license": "RN195188",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri-State Rehabilitation Inc. (Valdosta Pediatric Therapy Services)
• Triad Medical Alliance
• Carolyn Triestram
• Lori Trouille, ANP
• Heather Troyer
• Dalal Turalic, RBT
• Emina Turalic
• Jessica Turner
• Joy Turner, MD
• Lashannon Turner, MSW

• Family Nurse Practitioner in Valdosta, GA
• Providers in Valdosta, GA by specialty
• Family Nurse Practitioner in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 22, 2020; 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.