Gabrielle Renee Tucker, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

3365 Issued in OK

Practice address

114 W 7TH St
Okmulgee, OK 74447-5052

Phone

(918) 756-3330

NPI assigned

Jun 1, 2021

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Impact Rehab Consultants

  • Occupational Therapist
  • Okmulgee, OK
  • NPI 1972097657
  NPD

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

{
    "created_epoch": "1622505600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622505600000",
    "number": "1609442508",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "21712 W DUNCAN RD",
            "city": "HASKELL",
            "state": "OK",
            "postal_code": "744365019",
            "telephone_number": "918-927-2477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "114 W 7TH ST",
            "city": "OKMULGEE",
            "state": "OK",
            "postal_code": "744475052",
            "telephone_number": "918-756-3330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "GABRIELLE",
        "middle_name": "RENEE",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-06-01",
        "last_updated": "2021-06-01",
        "certification_date": "2021-06-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "OK",
            "license": "3365",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Deshawna Olivia Todd, B.A.
• Brandy Rene Treagesser
• Holly Trunk
• TSQ Inc
• Julie Anna Tucker-Barton, RRT
• Katie Turner Bumgarner, DPT
• Marcella Turner
• Twin Hills School
• Cathryn Louise Umsted
• Wesley Updike, M.D.

• Physical Therapy Assistant in Okmulgee, OK
• Providers in Okmulgee, OK by specialty
• Physical Therapy Assistant in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 1, 2021; 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.