Active NPI
William Everett Tucker Jr., MD
- Surgery Physician
- Little Rock, AR
National Provider Identifier
1598717373
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Surgery Physician
- License
- C4994
- Practice address
- 9500 Kanis Road
Ste 501
Little Rock, AR 72205 - Phone
- (501) 227-9080
- Fax
- (501) 227-0410
- NPI assigned
- May 17, 2006
- 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 |
|---|---|---|---|---|
| Surgery Physician | 208600000X | C4994 | AR | Primary |
Addresses
Primary practice location
9500 Kanis Road
Ste 501
Little Rock, AR 72205
Mailing address
9500 Kanis Road
Ste 501
Little Rock, AR 72205
Phone (501) 227-9080
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 104502001 | Medicaid | AR |
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)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| C4994 | AR | MD | Surgery Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| St. Vincent Medical Group | Surgery | Past | Accepting new patients |
Organizations & group practices 1
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.
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1147824000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1277251200000",
"number": "1598717373",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9500 KANIS ROAD",
"address_2": "STE 501",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-227-9080",
"fax_number": "501-227-0410"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9500 KANIS ROAD",
"address_2": "STE 501",
"city": "LITTLE ROCK",
"state": "AR",
"postal_code": "72205",
"telephone_number": "501-227-9080",
"fax_number": "501-227-0410"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "WILLIAM",
"middle_name": "EVERETT",
"name_prefix": "Dr.",
"name_suffix": "Jr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-05-17",
"last_updated": "2010-06-23",
"status": "A"
},
"taxonomies": [
{
"code": "208600000X",
"taxonomy_group": "",
"desc": "Surgery",
"state": "AR",
"license": "C4994",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "104502001",
"state": "AR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Little Rock, AR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 23, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.