Stephanie Nichole Tucker, COTA

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

057.005508 Issued in IL

Practice address

1301 E Deyoung St
Marion, IL 62959-3846

Phone

(618) 997-1365

NPI assigned

Nov 9, 2020

Last updated

Nov 19, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

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": "1604880000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605744000000",
    "number": "1457953002",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "508 N HORN ST",
            "city": "WEST FRANKFORT",
            "state": "IL",
            "postal_code": "628961847",
            "telephone_number": "618-579-6399"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1301 E DEYOUNG ST",
            "city": "MARION",
            "state": "IL",
            "postal_code": "629593846",
            "telephone_number": "618-997-1365"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "STEPHANIE",
        "middle_name": "NICHOLE",
        "credential": "COTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-11-09",
        "last_updated": "2020-11-19",
        "certification_date": "2020-11-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "IL",
            "license": "057.005508",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "SOAP",
            "endpointTypeDescription": "SOAP URL",
            "endpoint": "Marion",
            "affiliation": "N",
            "address_1": "1301 E DeYoung St",
            "city": "Marion",
            "state": "IL",
            "country_code": "US",
            "postal_code": "629593846",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Angela Trowbridge
• Danneille C Trujillo-Hansen, APRNBC
• TT Medco (True Test HRT)
• Bryan Tucker
• Gladstone A Tucker, MD
• Roberta Josephine Tunget, CCC-SLP
• Tamika S Turner
• Todd Twitty, PHARM D
• Keith Tyhurst, O.D.
• Ukeme Umana, M.D.

• Occupational Therapy Assistant in Marion, IL
• Providers in Marion, IL by specialty
• Occupational Therapy Assistant in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 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.

Verify at the official NPI Registry.