Active NPI
Alexis Pamala Tucker, ATC
- Athletic Trainer
- McCall, ID
National Provider Identifier
1467281204
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- License
- AT-858
- Practice address
- PO Box 2185
McCall, ID 83638 - Phone
- (541) 409-3039
- NPI assigned
- Jul 30, 2024
- Last updated
- Jul 30, 2024
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | AT-858 | ID | Primary |
Addresses
Primary practice location
PO Box 2185
McCall, ID 83638
Mailing address
PO Box 2185
McCall, ID 83638
Phone (541) 409-3039
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
| License | State | Type | Specialty |
|---|---|---|---|
| AT-858 | ID | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1722297600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1722297600000",
"number": "1467281204",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 2185",
"city": "MCCALL",
"state": "ID",
"postal_code": "83638",
"telephone_number": "541-409-3039"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "PO BOX 2185",
"city": "MCCALL",
"state": "ID",
"postal_code": "83638",
"telephone_number": "541-409-3039"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "ALEXIS",
"middle_name": "PAMALA",
"credential": "ATC",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-07-30",
"last_updated": "2024-07-30",
"certification_date": "2024-07-30",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "ID",
"license": "AT-858",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in McCall, ID
- Kaylie Sylvester
- Sze Pharmaceutical Corp (McCall Drug)
- Tanabell Health Services, Inc. (McCall Rehabilitation and Care Center)
- Thrifty Payless Inc (Rite Aid Pharmacy 05410)
- Paul D Traughber, M.D.
- Jackie J Turnipseed-Aymon, PA-C
- Two Rivers Dental
- Two Rivers Family & Cosmetic Dentistry, PA
- Unwind Spa Incorporated
- Urgent Health Care P.C.
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.