Kelli Tucker

Primary specialty

Occupational Therapy AssistantTaxonomy code 224Z00000X

License

OTA006820 Issued in OH

Practice address

2100 38TH St NW
Canton, OH 44709-2312

Phone

(330) 492-8136

NPI assigned

Aug 24, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Stark County Edcuational Service Center

  • Local Education Agency (LEA)
  • Canton, OH
  • NPI 1861681595
  NPD (past)

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

{
    "created_epoch": "1503532800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1503532800000",
    "number": "1477070118",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "140 SUPERIOR ST NE",
            "city": "BREWSTER",
            "state": "OH",
            "postal_code": "446131136",
            "telephone_number": "330-437-7847"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2100 38TH ST NW",
            "city": "CANTON",
            "state": "OH",
            "postal_code": "447092312",
            "telephone_number": "330-492-8136"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KELLI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-08-24",
        "last_updated": "2017-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "OH",
            "license": "OTA006820",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE-COTA",
            "identifier": "OTA006820",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• TSJ Agapecare Inc.
• Katherine Tsvetkoff, PA-C
• Dyan Marie Tucci, LPN
• Gretchen Renee Tucker, MA., LPC
• Jessica Leanne Tucker, APRN
• Mioara Tudosie, MD
• Brittney Tuel
• Mark G Tully, PH.D.
• Daniel Tummel, BSP, RPH
• Madison Tunder

• Occupational Therapy Assistant in Canton, OH
• Providers in Canton, OH by specialty
• Occupational Therapy Assistant in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2017; 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.