Individual provider Active NPI

Cammy Sue Tucker, RD

  • Registered Dietitian
  • Emporia, KS
National Provider Identifier
1538830666
Registry record updated Sep 28, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Registered DietitianTaxonomy code 133V00000X
License
1476 Issued in KS
Practice address
1201 W 12TH Ave
Emporia, KS 66801-2597
Phone
(620) 343-6800
NPI assigned
Sep 28, 2021
Last updated
Sep 28, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Registered Dietitian 133V00000X 1476 KS Primary

Addresses

Primary practice location

1201 W 12TH Ave
Emporia, KS 66801-2597

Mailing address

1201 W 12TH Ave
Emporia, KS 66801-2597
Phone (620) 343-6800

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211123002544 KS Practitioner - Registered Dietitian Or Nutrition Professional 4486044989 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1476KSMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
Newman Memorial County Hospital CurrentSince Mar 20, 2025 Accepting new patients
Newman Memorial County Hospital CurrentSince Mar 20, 2025 Accepting new patients
Newman Memorial County Hospital Past Accepting new patients

Locations

1201 W 12th Ave
Emporia, KS 66801
Phone (620) 343-2376

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": "1632787200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1632787200000",
    "number": "1538830666",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1201 W 12TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012597",
            "telephone_number": "620-343-6800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1201 W 12TH AVE",
            "city": "EMPORIA",
            "state": "KS",
            "postal_code": "668012597",
            "telephone_number": "620-343-6800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CAMMY",
        "middle_name": "SUE",
        "name_prefix": "Ms.",
        "credential": "RD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-09-28",
        "last_updated": "2021-09-28",
        "certification_date": "2021-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133V00000X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered",
            "state": "KS",
            "license": "1476",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Emporia, KS

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 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.