Kenneth B Tucker, MD

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

ME160121 Issued in FL

Practice address

180 N Watersound Pkwy
Inlet Beach, FL 32461-7274

Phone

(850) 278-3551

Fax

(850) 378-3596

NPI assigned

May 22, 2006

Last updated

Jul 19, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in AL, FL2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 2

Specialty

Internal Medicine

Education

University of Alabama School of Medicine, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Centerwell Home Health Home health agency, Shalimar, FL, CCN 107240
• Sacred Heart Hospital Hospital, Pensacola, FL, CCN 100025
• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
• Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.37
• Direct secure messaging: kenneth.tucker.1@9582.direct.athenahealth.com
• Direct secure messaging: ktucker14478@southeasthealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Ambulatory Family Planning Facility
  • Pensacola, FL
  • NPI 1962453308
  Medicare reassignment Care Compare group NPD
• Dothan Medical Associates, P.C.

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1972693778
  Medicare reassignment NPD
• Houston County Healthcare Authority

  dba Samc-Enterprise Medical Clinic

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment NPD
• Sacred Heart Health System Inc

  dba Ascension Rx 1411

  • Community/Retail Pharmacy
  • Pensacola, FL
  • NPI 1366260739
  NPD
• Sacred Heart Health System, Inc.

  dba Ascension Medical Group Sacred Heart

  • Primary Care Clinic/Center
  • Pensacola, FL
  • NPI 1043261498
  NPD
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center Medical Clinics

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Medcore Associates, PLLC

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1992524607
  NPD
• Pathology Laboratory Associates

  • Anatomic Pathology & Clinical Pathology Physician
  • Dothan, AL
  • NPI 1134190648
  NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Centerwell Health Services (Certified), Inc.

  dba Centerwell Home Health

  • Home Health Agency
  • Shalimar, FL
  • NPI 1518991215
  Care Compare affiliation Name & address match
• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Bay County Health System, LLC

  dba Ascension Sacred Heart Bay

  • General Acute Care Hospital
  • Panama City, FL
  • NPI 1720078041
  Care Compare affiliation
• Sacred Heart Health System, Inc.

  dba Ascension Sacred Heart Pensacola

  • General Acute Care Hospital
  • Pensacola, FL
  • NPI 1922032424
  Care Compare affiliation
• Houston County Healthcare Authority

  dba Southeast Alabama Medical Center

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1346294204",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 N WATERSOUND PKWY",
            "city": "INLET BEACH",
            "state": "FL",
            "postal_code": "324617274",
            "telephone_number": "850-278-3551",
            "fax_number": "850-378-3596"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KENNETH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160121",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000810983B",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000040677",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51040677",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maurissa Lynne Smith
• South Walton Eyecare LLC
• Lauren Stipp, M.D.
• Breanna E Streeter, BCBA
• Elizabeth B Tucker, MD
• Haidyn Grace Whitaker, RBT
• Marsha Ann White-Johnson, ARNP/FNP

• Internal Medicine Physician in Inlet Beach, FL
• Providers in Inlet Beach, FL by specialty
• Internal Medicine Physician in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 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.
• 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.