Elizabeth Dawn Tuck, FNP-C

Primary specialty

Primary Care Nurse PractitionerTaxonomy code 363LP2300X

License

4704272712 Issued in MI

Practice address

1866 S Morey Rd
Lake City, MI 49651-9190

Phone

(231) 908-8888

Fax

(833) 989-2153

NPI assigned

Jun 29, 2018

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in MI

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

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

V DermatologyGroup PAC ID 9739451063, 6 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Munson Healthcare Cadillac Hospital Hospital, Cadillac, MI, CCN 230081

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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.

• V Dermatology

  • Dermatology Physician
  • Traverse City, MI
  • NPI 1922536986
  Medicare reassignment Care Compare group

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

• Munson Healthcare Cadillac

  • Family Medicine Physician
  • Cadillac, MI
  • NPI 1487051611

  Hospital

  Care Compare affiliation
• Munson Healthcare Cadillac

  • General Acute Care Hospital
  • Cadillac, MI
  • NPI 1841696754
  Care Compare affiliation

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

{
    "created_epoch": "1530230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1664323200000",
    "number": "1609361807",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1866 S MOREY RD",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496519190",
            "telephone_number": "231-908-8888",
            "fax_number": "833-989-2153"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1866 S MOREY RD",
            "city": "LAKE CITY",
            "state": "MI",
            "postal_code": "496519190",
            "telephone_number": "231-908-8888",
            "fax_number": "833-989-2153"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCK",
        "first_name": "ELIZABETH",
        "middle_name": "DAWN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-29",
        "last_updated": "2022-09-28",
        "certification_date": "2022-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MI",
            "license": "4704272712",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "MI",
            "license": "4704272712",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "4704272712",
            "state": "MI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Suzanne Smith
• David Paul Taylor, HOME CARE GIVER
• Theresa A Thompson, CCC-SLP
• Danay Marie Tossey, PTS
• Marianne Totton, OTR/L
• Stephen C. Wheeler, LPC, CTRS, SCL

• Primary Care Nurse Practitioner in Lake City, MI
• Providers in Lake City, MI by specialty
• Primary Care Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.