Individual provider Active NPI

Mekka Jamelia Tucker, RN, BSN

  • Administrator Registered Nurse
  • Fayetteville, NC
National Provider Identifier
1306632021
Registry record updated Apr 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Administrator Registered NurseTaxonomy code 163WA2000X
License
343424 Issued in NC
Practice address
588 Executive PL Ste 201
Fayetteville, NC 28305-5187
Phone
(910) 491-3434
NPI assigned
Apr 18, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered Nurse 163WA2000X 343424 NC Primary

Addresses

Primary practice location

588 Executive PL Ste 201
Fayetteville, NC 28305-5187

Mailing address

2938 Lambrusco PL
Fayetteville, NC 28306-9282
Phone (910) 987-0532

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Bachelor on Science - Nursing, Registered Nurse

State licenses

LicenseStateTypeSpecialty
343424NCMDAdministrator Registered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Fayetteville Geriatric & Internal Medicine Clinic PA Current Accepting new patients
Coco Homecare, PLLC CurrentSince Nov 7, 2025 Accepting new patients

Locations

588 Executive Pl
Ste 201
Fayetteville, NC 28305
Phone (910) 491-3434

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": "1744934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1744934400000",
    "number": "1306632021",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2938 LAMBRUSCO PL",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283069282",
            "telephone_number": "910-987-0532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "588 EXECUTIVE PL STE 201",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283055187",
            "telephone_number": "910-491-3434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MEKKA",
        "middle_name": "JAMELIA",
        "credential": "RN, BSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-18",
        "last_updated": "2025-04-18",
        "certification_date": "2025-04-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Administrator",
            "state": "NC",
            "license": "343424",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 18, 2025; 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.