Individual provider Active NPI

Lauren Elise Tuck, MS RD LDN

  • Pediatric Nutrition Registered Dietitian
  • Ocala, FL
National Provider Identifier
1528659281
Registry record updated Jun 2, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
ND6325 Issued in FL
Practice address
7415 NE 28TH Ave
Ocala, FL 34479-8411
Phone
(352) 598-8191
NPI assigned
Jan 26, 2021
Last updated
Jun 2, 2021By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 2, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X ND6325 FL Primary

Addresses

Primary practice location

7415 NE 28TH Ave
Ocala, FL 34479-8411

Mailing address

PO Box 100296
Gainesville, FL 32610-0296
Phone (352) 627-9350

Other practice location 1

1600 SW Archer Rd
Gainesville, FL 32610-8411
Phone (352) 627-9350

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20210510001255 FL Practitioner - Registered Dietitian Or Nutrition Professional 8527477298 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
ND6325FLMDPediatric Nutrition Registered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Clinical Practice Association Inc CurrentSince May 14, 2021 Accepting new patients
Florida Clinical Practice Association Inc CurrentSince May 14, 2021 Accepting new patients

Locations

1600 SW Archer Rd
Gainesville, FL 32610
Phone (352) 265-0077

2001 SW 13th St
Gainesville, FL 32608
Phone (352) 265-8990

Networks

  • Optimum HealthCare HMO Network
  • Freedom Health HMO Network

Organizations & group practices 2

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": "1611619200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1528659281",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 100296",
            "city": "GAINESVILLE",
            "state": "FL",
            "postal_code": "326100296",
            "telephone_number": "352-627-9350",
            "fax_number": "352-273-9054"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7415 NE 28TH AVE",
            "city": "OCALA",
            "state": "FL",
            "postal_code": "344798411",
            "telephone_number": "352-598-8191"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1600 SW Archer Rd",
            "address_purpose": "LOCATION",
            "city": "Gainesville",
            "state": "FL",
            "postal_code": "326108411",
            "country_code": "US",
            "telephone_number": "352-627-9350",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCK",
        "first_name": "LAUREN",
        "middle_name": "ELISE",
        "name_prefix": "Mrs.",
        "credential": "MS RD LDN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2021-01-26",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "FL",
            "license": "ND6325",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ocala, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.