Perry Lynn Tucker

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

875 State Route VV
Kennett, MO 63857-9108

Phone

(573) 888-5925

NPI assigned

Oct 17, 2018

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1539734400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539734400000",
    "number": "1346716362",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "925 STATE ROUTE VV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638573822",
            "telephone_number": "573-888-5925"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "875 STATE ROUTE VV",
            "city": "KENNETT",
            "state": "MO",
            "postal_code": "638579108",
            "telephone_number": "573-888-5925"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PERRY",
        "middle_name": "LYNN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-17",
        "last_updated": "2018-10-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tri-County Group XV, Inc. (Elara Caring)
• Denise Elaine Trout
• Taylor Chanea Trover
• Jadacee Leshea Tucker
• Jeremy Allen Tucker
• Soros Tungsiripat, M.D.
• Bonita Turner
• Donna Gail Turner, BS
• Herman Leon Turner, D.C.
• Twin Rivers Emergency Physicians, LLC

• Peer Specialist in Kennett, MO
• Providers in Kennett, MO by specialty
• Peer Specialist in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 17, 2018; 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.