NPIMap

Individual provider Active NPI

Elizabeth B Tucker, MD

  • Internal Medicine Physician
  • Inlet Beach, FL
National Provider Identifier
1487608345
Registry record updated Jul 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
ME160145 Issued in FL
Practice address
12805 US Highway 98 E Unit G201
Inlet Beach, FL 32461-9632
Phone
(850) 278-3466
Fax
(850) 278-3467
NPI assigned
May 22, 2006
Last updated
Jul 19, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X ME160145 FL Primary

Addresses

Primary practice location

12805 US Highway 98 E Unit G201
Inlet Beach, FL 32461-9632

Mailing address

4205 Belfort Rd Ste 4015
Jacksonville, FL 32216-3623
Phone (904) 450-6063

Other identifiers 2

IdentifierTypeStateIssuer
000045066MedicaidAL
51045066OtherALBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL, FL2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20060223000623 AL Practitioner - Internal Medicine 1850307166 Reassigns benefits to 1 organization
I20230313002653 FL Practitioner - Internal Medicine 1850307166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of Alabama School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Sacred Heart Health System IncGroup PAC ID 3779491386, 373 clinicians

Practice addresses (Care Compare)

12805 US Hwy 98 E
Unit G201
Inlet Beach, FL 32461-9632
Phone (850) 278-3390

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Sacred Heart Health System, Inc. CurrentSince Feb 27, 2023 Accepting new patients
Sacred Heart Health System Inc CurrentSince Feb 27, 2023 Accepting new patients
Sacred Heart Health System, Inc. Current Accepting new patients
Dothan Medical Associates, P.C. Internal Medicine CurrentSince Aug 1, 1998 Accepting new patients

Locations

1108 Ross Clark Cir
Dothan, AL 36301
Phone (334) 712-3635

1118 Ross Clark Cir
Ste 100
Dothan, AL 36301
Phone (334) 794-1148

12805 US Highway 98 E
Unit G201
Inlet Beach, FL 32461
Phone (850) 278-3390

4205 Belfort Rd
Ste 4015
Jacksonville, FL 32216
Phone (904) 296-5691

4501 N Davis Hwy
Ste A
Pensacola, FL 32503
Phone (850) 476-9000

Interoperability endpoints

  • Direct secure messaging: elizabeth.tucker.1@9582.direct.athenahealth.com
  • FHIR API: https://fhir-api.fhirprod.aws.greenwayhealth.com/fhir/R4/2.16.840.1.113883.3.441.37

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1148256000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1689724800000",
    "number": "1487608345",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4205 BELFORT RD STE 4015",
            "city": "JACKSONVILLE",
            "state": "FL",
            "postal_code": "322163623",
            "telephone_number": "904-450-6063",
            "fax_number": "904-539-4091"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "12805 US HIGHWAY 98 E UNIT G201",
            "city": "INLET BEACH",
            "state": "FL",
            "postal_code": "324619632",
            "telephone_number": "850-278-3466",
            "fax_number": "850-278-3467"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ELIZABETH",
        "middle_name": "B",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-22",
        "last_updated": "2023-07-19",
        "certification_date": "2023-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "FL",
            "license": "ME160145",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000045066",
            "state": "AL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "51045066",
            "state": "AL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Inlet Beach, FL

Sources for this page

Verify at the official NPI Registry.