Sandra Tucker

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

200 N Alabama St
Crossett, AR 71635-2808

Phone

(870) 415-7845

NPI assigned

Jun 14, 2023

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in AR

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Interventions Behavioral Health Service LLC

  • Mental Health Counselor
  • Crossett, AR
  • NPI 1841689163
  Medicare reassignment NPD
• Mainline Health Systems Inc

  • Federally Qualified Health Center (FQHC)
  • Monticello, AR
  • NPI 1205163540
  NPD (past)

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

{
    "created_epoch": "1686700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1725926400000",
    "number": "1467136804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2735 HIGHWAY 82 E",
            "city": "MONTROSE",
            "state": "AR",
            "postal_code": "716589436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 N ALABAMA ST",
            "city": "CROSSETT",
            "state": "AR",
            "postal_code": "716352808",
            "telephone_number": "870-415-7845"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SANDRA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-06-14",
        "last_updated": "2024-09-10",
        "certification_date": "2024-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tice Chiropractic Clinic
• John D Tice, DC
• Teresa R Tice, DC
• Casey Nicole Timmons
• Alisha Chantel Tucker
• Vanessa Tucker
• Daniel William Van Dyck, PTA
• Wal-Mart Stores, Inc.
• Walgreen Co
• Sherry Crook Walker, PTA

• Social Worker in Crossett, AR
• Providers in Crossett, AR by specialty
• Social Worker in Arkansas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.