Active NPI
Kyla Marie Tucker, NP-C
- Family Nurse Practitioner
- Dayville, CT
National Provider Identifier
1366078693
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- 8802
- Practice address
- 545 Hartford Pike
Dayville, CT 06241-2150 - Phone
- (860) 412-9190
- NPI assigned
- Mar 18, 2020
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 8802 | CT | Primary |
Addresses
Primary practice location
545 Hartford Pike
Dayville, CT 06241-2150
Mailing address
14 Harrison St
Putnam, CT 06260-1226
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
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 8802 | CT | MD | Mental Health Counselor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Kyla Tucker, Aprn, FNP-C | Current | Accepting new patients | |
| Eastern Connecticut Rehabili | Past | Accepting new patients |
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.
-
- Health Service Clinic/Center
- Putnam, CT
- NPI 1023739547
-
- Physical Therapy Clinic/Center
- Gales Ferry, CT
- NPI 1700895729
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1584489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1584489600000",
"number": "1366078693",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "14 HARRISON ST",
"city": "PUTNAM",
"state": "CT",
"postal_code": "062601226"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "545 HARTFORD PIKE",
"city": "DAYVILLE",
"state": "CT",
"postal_code": "062412150",
"telephone_number": "860-412-9190"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "KYLA",
"middle_name": "MARIE",
"credential": "NP-C",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2020-03-18",
"last_updated": "2020-03-18",
"certification_date": "2020-03-18",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "CT",
"license": "8802",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Dayville, CT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.