Active NPI
Melissa S Tuck-White, M.D.
- Family Medicine Physician
- Las Vegas, NV
National Provider Identifier
1306973979
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 23624
- Practice address
- 410 S Rampart Blvd Ste 420
Las Vegas, NV 89145-5749 - Phone
- (702) 240-4200
- Fax
- (702) 548-4253
- NPI assigned
- Feb 28, 2007
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 4
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | M9065 | TX | |
| Family Medicine Physician | 207Q00000X | 10309A | WY | |
| Family Medicine Physician | 207Q00000X | DR.0057992 | CO | |
| Family Medicine Physician | 207Q00000X | 23624 | NV | Primary |
Addresses
Primary practice location
410 S Rampart Blvd Ste 420
Las Vegas, NV 89145-5749
Mailing address
5050 Powderhouse Rd
Cheyenne, WY 82009-4800
Phone (307) 634-1311
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 192649501 | Medicaid | TX |
Medicare participation
Medicare enrollment files- 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: Yes
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23624 | NV | MD | Pharmacist |
| DR.0057992 | CO | MD | Family Medicine Physician |
| M9065 | TX | MD | Family Medicine Physician |
| 10309A | WY | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Galileo Medical Group Ga, P.C. | Family Medicine | Current | Accepting new patients |
Locations
4300 Paces Ferry Rd SE
Ste 500
Atlanta, GA 30339
Phone (404) 496-8960
64 Bleecker St
New York, NY 10012
Phone (302) 313-1584
Organizations & group practices 1
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": "1172620800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1688342400000",
"number": "1306973979",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5050 POWDERHOUSE RD",
"city": "CHEYENNE",
"state": "WY",
"postal_code": "820094800",
"telephone_number": "307-634-1311",
"fax_number": "307-634-1271"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "410 S RAMPART BLVD STE 420",
"city": "LAS VEGAS",
"state": "NV",
"postal_code": "891455749",
"telephone_number": "702-240-4200",
"fax_number": "702-548-4253"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCK-WHITE",
"first_name": "MELISSA",
"middle_name": "S",
"name_prefix": "Dr.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-02-28",
"last_updated": "2023-07-03",
"certification_date": "2023-07-03",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "TX",
"license": "M9065",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "WY",
"license": "10309A",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "CO",
"license": "DR.0057992",
"primary": false
},
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "NV",
"license": "23624",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "192649501",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Las Vegas, NV
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2023; 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.