Active NPI
Brady Raymond Tucker
- Pharmacist
- Sedona, AZ
National Provider Identifier
1528577079
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Pharmacist
- License
- S023002
- Practice address
- 20 Airport Rd
Sedona, AZ 86336-5805 - Phone
- (928) 282-8569
- NPI assigned
- Sep 28, 2017
- Last updated
- Mar 20, 2022
- Sex
- Male
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Pharmacist | 183500000X | S023002 | AZ | Primary |
Addresses
Primary practice location
20 Airport Rd
Sedona, AZ 86336-5805
Mailing address
5123 E Hermosa Dr
Cornville, AZ 86325-5149
Phone (518) 223-5998
Other practice location 1
2610 E Route 66
Flagstaff, AZ 86004-4305
Phone (928) 773-1155
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| S023002 | AZ | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Walgreen Co | Past | Accepting new patients | |
| German Dobson CVS LLC | Past | Accepting new patients | |
| German Dobson CVS LLC | Past | Accepting new patients |
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": "1506556800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1647734400000",
"number": "1528577079",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5123 E HERMOSA DR",
"city": "CORNVILLE",
"state": "AZ",
"postal_code": "863255149",
"telephone_number": "518-223-5998"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "20 AIRPORT RD",
"city": "SEDONA",
"state": "AZ",
"postal_code": "863365805",
"telephone_number": "928-282-8569"
}
],
"practiceLocations": [
{
"address_1": "2610 E Route 66",
"address_purpose": "LOCATION",
"city": "Flagstaff",
"state": "AZ",
"postal_code": "860044305",
"country_code": "US",
"telephone_number": "928-773-1155",
"fax_number": "928-773-1652",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "TUCKER",
"first_name": "BRADY",
"middle_name": "RAYMOND",
"name_prefix": "Dr.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2017-09-28",
"last_updated": "2022-03-20",
"certification_date": "2022-03-20",
"status": "A"
},
"taxonomies": [
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "AZ",
"license": "S023002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sedona, AZ
- Jacqueline B. Thompson, SLPA
- Tim Mullins LPC LLC (Tim Mullins LPC)
- Mittie Anna Tollefson, BC-HIS
- Julia M Trainor, ARNP
- Tribe Wellness TMS PLLC
- Dominic Rex Valdes Mumma, NMD
- Jennifer Marie Vanrooyen, M.S CCC SP
- Dianna Vansanford, LPC
- Verde Community Healthcare LLC
- Verde Valley Medical Center (Northern Arizona Healthcare - Sedona)
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 20, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.