Shelby Tucker

Primary specialty

Peer SpecialistTaxonomy code 175T00000X

Practice address

1824 S Van Buren St
Enid, OK 73703-7903

Phone

(405) 230-1168

NPI assigned

Apr 28, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1619568000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1682294400000",
    "number": "1437732435",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "702 N GRAND ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737013221",
            "telephone_number": "580-234-3791"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1824 S VAN BUREN ST",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737037903",
            "telephone_number": "405-230-1168"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SHELBY",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-28",
        "last_updated": "2023-04-24",
        "certification_date": "2023-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "OK",
            "license": "10939126",
            "primary": false
        },
        {
            "code": "175T00000X",
            "taxonomy_group": "",
            "desc": "Peer Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Timothy David Trojan, MD
• Trung B Nguyen MD Inc
• Connie Jill Tucker-Smith, BS
• Keelie Renee Tucker, MD
• Quinche Tucker, LPC-CANDIDATE
• Nancye Turner, LPN, IBCLC
• Lori Ann Tydings
• Hilary Ugwu
• Uhs of Oklahoma Inc
• Uhs of Oklahoma, LLC

• Peer Specialist in Enid, OK
• Providers in Enid, OK by specialty
• Peer Specialist in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 24, 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.

Verify at the official NPI Registry.