Individual provider Active NPI

Lindsay Anne Tucker, AU.D.

  • Audiologist
  • Pocatello, ID
National Provider Identifier
1528376282
Registry record updated Aug 5, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
AUD-2000 Issued in ID
Practice address
650 Memorial Dr
Pocatello, ID 83209-0001
Phone
(208) 233-4339
NPI assigned
Sep 15, 2010
Last updated
Aug 5, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA12263 AZ
Audiologist 231H00000X AUD-2000 ID Primary

Addresses

Primary practice location

650 Memorial Dr
Pocatello, ID 83209-0001

Mailing address

2627 N 3Rd St
Phoenix, AZ 85004-1113
Phone (208) 202-0402

Other identifiers 1

IdentifierTypeStateIssuer
1366570244MedicaidAZ

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210126000191 AZ Practitioner - Qualified Audiologist 2567682982 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
AUD-2000IDMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Uplift Hearing Audiologist CurrentSince Dec 17, 2023 Accepting new patients
Robert J. Lee, M.D., PC CurrentSince Feb 27, 2018 Accepting new patients
Arizona Ear Center PC CurrentSince Oct 8, 2020 Accepting new patients

Locations

2325 E Camelback Rd
Phoenix, AZ 85016

2627 N 3rd St
Ste 201
Phoenix, AZ 85004
Phone (602) 277-4327

3446 S 15th E
Idaho Falls, ID 83404
Phone (208) 522-4409

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1284508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1596585600000",
    "number": "1528376282",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2627 N 3RD ST",
            "city": "PHOENIX",
            "state": "AZ",
            "postal_code": "850041113",
            "telephone_number": "208-202-0402"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "650 MEMORIAL DR",
            "city": "POCATELLO",
            "state": "ID",
            "postal_code": "832090001",
            "telephone_number": "208-233-4339"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "LINDSAY",
        "middle_name": "ANNE",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-09-15",
        "last_updated": "2020-08-05",
        "certification_date": "2020-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA12263",
            "primary": false
        },
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "ID",
            "license": "AUD-2000",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1366570244",
            "state": "AZ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Pocatello, ID

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.