Active NPI
Janna Marie Tuck, M. D.
- Allergy & Immunology Physician
- Santa Fe, NM
National Provider Identifier
1346230646
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Allergy & Immunology Physician
- License
- MD2017-0858
- Practice address
- 1651 Galisteo St Ste 8
Santa Fe, NM 87505-4752 - Phone
- (505) 820-9870
- Fax
- (505) 983-1265
- NPI assigned
- Oct 27, 2005
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Allergy & Immunology Physician | 207K00000X | 108098 | MO | |
| Allergy & Immunology Physician | 207K00000X | MD2017-0858 | NM | Primary |
Addresses
Primary practice location
1651 Galisteo St Ste 8
Santa Fe, NM 87505-4752
Mailing address
Dept. 453 PO Box 1000
Memphis, TN 38148-0001
Phone (828) 575-2625
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 55771718 | Medicaid | NM | |
| 637008AU6T | Other | NM | MEDICARE PTAN |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 108098 | MO | MD | Allergy & Immunology Physician |
| MD2017-0858 | NM | MD | Allergy & Immunology Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1130371200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1651017600000",
"number": "1346230646",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "DEPT. 453 PO BOX 1000",
"city": "MEMPHIS",
"state": "TN",
"postal_code": "381480001",
"telephone_number": "828-575-2625",
"fax_number": "828-350-2174"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1651 GALISTEO ST STE 8",
"city": "SANTA FE",
"state": "NM",
"postal_code": "875054752",
"telephone_number": "505-820-9870",
"fax_number": "505-983-1265"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCK",
"first_name": "JANNA",
"middle_name": "MARIE",
"name_prefix": "Dr.",
"credential": "M. D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-10-27",
"last_updated": "2022-04-27",
"certification_date": "2022-04-27",
"status": "A"
},
"taxonomies": [
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "MO",
"license": "108098",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "NM",
"license": "MD2017-0858",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "55771718",
"state": "NM"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICARE PTAN",
"identifier": "637008AU6T",
"state": "NM"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Santa Fe, NM
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.