Melissa Wilson Tucker, M.D.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

22560 Issued in MS

Practice address

3680 Sangani Blvd
Diberville, MS 39540-8703

Phone

(228) 354-9300

Fax

(228) 354-9301

NPI assigned

Jun 6, 2007

Last updated

Sep 17, 2014By the provider in NPPES

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

Enrolled in MS

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

Practice roles

Locations

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

• Memorial Hospital at Gulfport

  • Urology Physician
  • Gulfport, MS
  • NPI 1093142598
  Medicare reassignment
• Memorial Hospital at Gulfport

  dba Memorial Surgery Center Cedar Lake

  • General Acute Care Hospital
  • Biloxi, MS
  • NPI 1215546635
  NPD
• Memorial Hospital at Gulfport

  • Family Medicine Physician
  • Long Beach, MS
  • NPI 1881021350
  NPD
• Memorial Hospital at Gulfport

  dba Memorial Emergency Physicians

  • Emergency Medicine Physician
  • Gulfport, MS
  • NPI 1962780379
  NPD

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

{
    "created_epoch": "1181088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1410912000000",
    "number": "1649473919",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3680 SANGANI BLVD",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395408703",
            "telephone_number": "228-354-9300",
            "fax_number": "228-354-9301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3680 SANGANI BLVD",
            "city": "DIBERVILLE",
            "state": "MS",
            "postal_code": "395408703",
            "telephone_number": "228-354-9300",
            "fax_number": "228-354-9301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MELISSA",
        "middle_name": "WILSON",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-06-06",
        "last_updated": "2014-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MS",
            "license": "22560",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Total Renal Care Inc (Gulf Islands Home Training)
• Christina Tran
• Doan Khanh Tran, D.M.D
• Debra L Traughber, LPC-S, ACS
• Debra Scardino Treutel, RPH
• Angelos Basil Vamvakas, M.D.
• Vitality Wellness Clinic LLC (Vitality Medical Clinic and Spa)
• Wal-Mart Stores East , LP (Walmart Pharmacy 10-6166)
• Wal-Mart Stores East LP (Wal-Mart Pharmacy 10-2715)
• Wal-Mart Stores East, LP (Vision Center 30-2715)

• Family Medicine Physician in D'Iberville, MS
• Providers in D'Iberville, MS by specialty
• Family Medicine Physician in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 17, 2014; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.