Individual provider Active NPI

Kara Earthman Tucker

  • Women's Health Nurse Practitioner
  • Hendersonville, TN
National Provider Identifier
1609319136
Registry record updated Dec 17, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Women's Health Nurse PractitionerTaxonomy code 363LW0102X
License
22061 Issued in TN
Practice address
353 New Shackle Island Rd
Suite 221B
Hendersonville, TN 37075-2379
Phone
(615) 822-3880
Fax
(615) 264-1664
NPI assigned
Dec 1, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 17, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Women's Health Nurse Practitioner 363LW0102X 22061 TN Primary

Addresses

Primary practice location

353 New Shackle Island Rd
Suite 221B
Hendersonville, TN 37075-2379

Mailing address

3024 Business Park Cir
Goodlettsville, TN 37072-3132
Phone (615) 851-6033

Other practice location 1

4322 Harding Pike Ste 329
Nashville, TN 37205-2664
Phone (615) 630-6969

Other identifiers 2

IdentifierTypeStateIssuer
Q026121MedicaidTN
6091937OtherSDBLUE CROSS BLUE SHIELD

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

State licenses

LicenseStateTypeSpecialty
22061TNMDWomen's Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Woods Gynecology, PC 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": "1480550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608163200000",
    "number": "1609319136",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3024 BUSINESS PARK CIR",
            "city": "GOODLETTSVILLE",
            "state": "TN",
            "postal_code": "370723132",
            "telephone_number": "615-851-6033",
            "fax_number": "615-851-2018"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 NEW SHACKLE ISLAND RD",
            "address_2": "SUITE 221B",
            "city": "HENDERSONVILLE",
            "state": "TN",
            "postal_code": "370752379",
            "telephone_number": "615-822-3880",
            "fax_number": "615-264-1664"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4322 Harding Pike Ste 329",
            "address_purpose": "LOCATION",
            "city": "Nashville",
            "state": "TN",
            "postal_code": "372052664",
            "country_code": "US",
            "telephone_number": "615-630-6969",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KARA",
        "middle_name": "EARTHMAN",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-12-01",
        "last_updated": "2020-12-17",
        "certification_date": "2020-12-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LW0102X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Women's Health",
            "state": "TN",
            "license": "22061",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "Q026121",
            "state": "TN"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "6091937",
            "state": "SD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hendersonville, TN

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 17, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.