Individual provider Active NPI

Richard Lamar Tucker

  • Emergency Registered Nurse
  • Lake City, FL
National Provider Identifier
1457595027
Registry record updated Apr 27, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Registered NurseTaxonomy code 163WE0003X
License
RN 9262859 Issued in FL
Practice address
520 SW Beauford PL
Lake City, FL 32024-5244
Phone
(386) 752-3332
Fax
(386) 752-3332
NPI assigned
Apr 27, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 27, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Registered Nurse 163WE0003X RN 9262859 FL Primary

Addresses

Primary practice location

520 SW Beauford PL
Lake City, FL 32024-5244

Mailing address

520 SW Beauford PL
Lake City, FL 32024-5244
Phone (386) 752-3332

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
RN 9262859FLMDEmergency Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1240790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240790400000",
    "number": "1457595027",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "520 SW BEAUFORD PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320245244",
            "telephone_number": "386-752-3332",
            "fax_number": "386-752-3332"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 SW BEAUFORD PL",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320245244",
            "telephone_number": "386-752-3332",
            "fax_number": "386-752-3332"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "RICHARD",
        "middle_name": "LAMAR",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-04-27",
        "last_updated": "2009-04-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WE0003X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Emergency",
            "state": "FL",
            "license": "RN 9262859",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 27, 2009; 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.