Daniel R Tuckey, M.D.

Primary specialty

Pediatrics PhysicianTaxonomy code 208000000X

License

4301078791 Issued in MI

Practice address

4389 Beaufort Rd.
Havelock, NC 28532

Phone

(252) 466-0244

Fax

(252) 466-0127

NPI assigned

Oct 21, 2005

Sex

Male

Sole proprietor

No

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 MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

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

{
    "created_epoch": "1129852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623283200000",
    "number": "1497744429",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PSC BOX 8023",
            "city": "CHERRY POINT",
            "state": "NC",
            "postal_code": "285335008",
            "telephone_number": "252-466-0244",
            "fax_number": "252-466-0127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4389 BEAUFORT RD.",
            "city": "HAVELOCK",
            "state": "NC",
            "postal_code": "28532",
            "telephone_number": "252-466-0244",
            "fax_number": "252-466-0127"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "700 24th St",
            "address_2": "Wilkerson Pediatric Clinic",
            "address_purpose": "LOCATION",
            "city": "Fort Lee",
            "state": "VA",
            "postal_code": "238011716",
            "country_code": "US",
            "telephone_number": "804-734-9125",
            "fax_number": "804-734-9011",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKEY",
        "first_name": "DANIEL",
        "middle_name": "R",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-10-21",
        "last_updated": "2021-06-10",
        "certification_date": "2021-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MI",
            "license": "4301078791",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mary Anna Tayloe
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• Kaitlyn Thomesen, MD
• Carolyn Welch Thompson, PTA
• Tara-Dawm R Tootle, PHARMD
• United Home Care Inc
• Amanda Marie Van Epps, LCMHCA
• Visions Community Outreachg
• Erica C Vizueth
• Rafalia Vogiatzis, RD

• Pediatrics Physician in Havelock, NC
• Providers in Havelock, NC by specialty
• Pediatrics Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2021; 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.