Individual provider Active NPI

Marjorie Lynne Tucker, NP

  • Family Nurse Practitioner
  • Longview, TX
National Provider Identifier
1538875729
Registry record updated Aug 24, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1107923 Issued in TX
Practice address
1809 W Loop 281 Ste 122
Longview, TX 75604-2522
Phone
(903) 525-9397
NPI assigned
Jan 30, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 24, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1107923 TX Primary

Addresses

Primary practice location

1809 W Loop 281 Ste 122
Longview, TX 75604-2522

Mailing address

1809 W Loop 281
Longview, TX 75604-2571
Phone (903) 525-9397

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230810004212 TX Practitioner - Nurse Practitioner 1557723392 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Associated Clinicians of East TexasGroup PAC ID 4789957440, 106 clinicians

Practice addresses (Care Compare)

805 Medical Cir
Longview, TX 75605-5130
Phone (903) 232-8100

Hospital & facility affiliations

  • Onesource Home Care Inc Home health agency, Longview, TX, CCN 679138
  • Longview Regional Medical Center Hospital, Longview, TX, CCN 450702

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1107923TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Spine and Pain Clinic of Texas CurrentSince May 1, 2023 Accepting new patients
East Texas Family Support Clinic CurrentSince Sep 5, 2023 Accepting new patients
Associated Clinicians of East Texas CurrentSince Dec 27, 2023 Accepting new patients
Associated Clinicians of East Texas Past Accepting new patients

Locations

2507 Medical Row
Ste 103
Grand Prairie, TX 75051
Phone (214) 256-3900

805 Medical Cir
Longview, TX 75605
Phone (903) 232-8100

1809 W Loop 281
Ste 122
Longview, TX 75604
Phone (903) 525-9397

1809 W Loop 281
Longview, TX 75604
Phone (214) 256-3900

707 Hollybrook Dr
Ste 500
Longview, TX 75605
Phone (903) 232-8276

6300 Stonewood Dr
Ste 206
Plano, TX 75024
Phone (972) 769-8700

3728 Southpark Dr
Ste 200
Tyler, TX 75703
Phone (903) 525-9397

Interoperability endpoints

  • Direct secure messaging: marjorie.tucker.1@23550.direct.athenahealth.com

Organizations & group practices 4

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1675036800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692835200000",
    "number": "1538875729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1809 W LOOP 281",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042571",
            "telephone_number": "903-525-9397"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1809 W LOOP 281 STE 122",
            "city": "LONGVIEW",
            "state": "TX",
            "postal_code": "756042522",
            "telephone_number": "903-525-9397"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MARJORIE",
        "middle_name": "LYNNE",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-01-30",
        "last_updated": "2023-08-24",
        "certification_date": "2023-08-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1107923",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Longview, TX

Sources for this page

Verify at the official NPI Registry.