Active NPI
Michael Douglas Tuckey, D.C.
- Chiropractor
- Indianapolis, IN
National Provider Identifier
1467676411
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Chiropractor
- License
- 08001328
- Practice address
- 5023 E 56TH St
Suite 100
Indianapolis, IN 46226-1474 - Phone
- (317) 351-0345
- NPI assigned
- Apr 12, 2007
- Last updated
- Jul 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Chiropractor | 111N00000X | 08001328 | IN | Primary |
Addresses
Primary practice location
5023 E 56TH St
Suite 100
Indianapolis, IN 46226-1474
Mailing address
5023 E 56TH St
Suite 100
Indianapolis, IN 46226-1474
Phone (317) 351-0345
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 0000000353133 | Other | IN | BCBS |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in IN
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20041122001045 | IN | Practitioner - Chiropractic | 4789649492 | Practice locations: Indianapolis, IN |
Care Compare profile
Medicare Care Compare- Specialty
- Chiropractic
- Education
- Palmer College Chiropractic - Davenport, 1991
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
5023 E 56TH St
Indianapolis, IN 46226-1471
Phone (317) 351-0345
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 08001328 | IN | MD | Chiropractor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176336000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1467676411",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5023 E 56TH ST",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462261474",
"telephone_number": "317-351-0345"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5023 E 56TH ST",
"address_2": "SUITE 100",
"city": "INDIANAPOLIS",
"state": "IN",
"postal_code": "462261474",
"telephone_number": "317-351-0345"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKEY",
"first_name": "MICHAEL",
"middle_name": "DOUGLAS",
"credential": "D.C.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-04-12",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "111N00000X",
"taxonomy_group": "",
"desc": "Chiropractor",
"state": "IN",
"license": "08001328",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BCBS",
"identifier": "0000000353133",
"state": "IN"
}
],
"endpoints": [],
"other_names": []
}Other providers in Indianapolis, IN
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.