Active NPI
Vernon O Tucker, CRNA
- Certified Registered Nurse Anesthetist
- Rogers, AR
National Provider Identifier
1417937657
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Certified Registered Nurse Anesthetist
- License
- C000969
- Practice address
- 3728 S Pinnacle Hills Pkwy
Rogers, AR 72758-8897 - Phone
- (479) 790-3328
- NPI assigned
- Jan 21, 2006
- Sex
- Male
- 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 |
|---|---|---|---|---|
| Certified Registered Nurse Anesthetist | 367500000X | C000969 | AR | Primary |
Addresses
Primary practice location
3728 S Pinnacle Hills Pkwy
Rogers, AR 72758-8897
Mailing address
PO Box 583
Lowell, AR 72745-0583
Phone (888) 991-1101
Other identifiers 3
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 917321903 | Medicaid | MO | |
| 5T077 | Other | AR | BCBS |
| 134260701 | Medicaid | AR |
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 |
|---|---|---|---|
| C969 | AR | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ouachita Regional Anesthesia PLLC | Past | Accepting new patients | |
| Anesthesia Services of Benton County PA | Past | Accepting new patients | |
| Northeast Arkansas Clinic Charitable Foundation, Inc. | Past | Accepting new patients | |
| Precision Surgical Center of Northwest Arkansas, LLC | Past | Accepting new patients |
Organizations & group practices 4
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.
-
- Anesthesiology Physician
- Rogers, AR
- NPI 1013084482
-
dba NEA Baptist Clinic Anesthesia
- Anesthesiology Physician
- Jonesboro, AR
- NPI 1992036032
-
- Anesthesiology Physician
- Hot Springs, AR
- NPI 1982699153
-
- Ambulatory Surgical Clinic/Center
- Rogers, AR
- NPI 1194209437
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1137801600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1675728000000",
"number": "1417937657",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 583",
"city": "LOWELL",
"state": "AR",
"postal_code": "727450583",
"telephone_number": "888-991-1101",
"fax_number": "903-787-5854"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3728 S PINNACLE HILLS PKWY",
"city": "ROGERS",
"state": "AR",
"postal_code": "727588897",
"telephone_number": "479-790-3328"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "VERNON",
"middle_name": "O",
"credential": "CRNA",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-01-21",
"last_updated": "2023-02-07",
"certification_date": "2023-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "367500000X",
"taxonomy_group": "",
"desc": "Nurse Anesthetist, Certified Registered",
"state": "AR",
"license": "C000969",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "917321903",
"state": "MO"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "5T077",
"state": "AR"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "134260701",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Rogers, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.