Individual provider Active NPI

J Rhet Tucker, DMD

  • Oral and Maxillofacial Surgery (Dentist)
  • Charleston, SC
National Provider Identifier
1659454155
Registry record updated Jul 29, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Oral and Maxillofacial Surgery (Dentist)Taxonomy code 1223S0112X
License
12424039-9921 Issued in UT
Practice address
171 Ashley Ave
Charleston, SC 29425-8908
Phone
(843) 792-1414
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
General Practice Dentistry 1223G0001X 2901019477 MI
Prosthodontics 1223P0700X 2901019477 MI
Prosthodontics 1223P0700X 8593 SC
Oral and Maxillofacial Surgery (Dentist) 1223S0112X 12424039-9921 UT Primary

Addresses

Primary practice location

171 Ashley Ave
Charleston, SC 29425-8908

Mailing address

PO Box 751461
Charlotte, NC 28275-1461
Phone (843) 792-1414

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC, UT2 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: No
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20151027000115 SC Practitioner - Oral Surgery 6305155706 Reassigns benefits to 1 organization
I20230504001989 UT Practitioner - Oral Surgery 6305155706 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Oral Surgery
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
University of Utah Adult ServicesGroup PAC ID 0941525273, 1,758 clinicians

Practice addresses (Care Compare)

50 N Medical Dr
Salt Lake City, UT 84132-0100
Phone (801) 585-3229

Merit-based Incentive Payment System (MIPS)

Final score
89.77 of 100Reported as group
Quality
91.47
Promoting interoperability
100
Improvement activities
40
Cost
74.42

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2901019477MIMDGeneral Practice Dentistry

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services Current Accepting new patients
University of Utah Dental Services Current Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 13, 2015 Accepting new patients
University of Utah Adult Services CurrentSince Jan 28, 2023 Accepting new patients
University of Utah Adult Services General Practice CurrentSince Jan 28, 2023 Accepting new patients
University Medical Associates of the Medical University of South Carol CurrentSince Aug 13, 2015 Accepting new patients
University of Utah Dental Services CurrentSince Jan 28, 2023 Accepting new patients
University of Utah Dental Services Oral and Maxillofacial Surgery CurrentSince Jan 28, 2023 Accepting new patients
Bronson Lakeview Hospital Past Accepting new patients

Locations

171 Ashley Ave
Charleston, SC 29425
Phone (843) 792-2123

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

127 S 500 E
Salt Lake Cty, UT 84102

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

530 S Wakara Way
Slc, UT 84108
Phone (801) 581-8951

Interoperability endpoints

  • Direct secure messaging: jtucker536694@direct.med.utah.edu

Organizations & group practices 9

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": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1722211200000",
    "number": "1659454155",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 751461",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282751461",
            "telephone_number": "843-792-1414"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 ASHLEY AVE",
            "city": "CHARLESTON",
            "state": "SC",
            "postal_code": "294258908",
            "telephone_number": "843-792-1414"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "J",
        "middle_name": "RHET",
        "name_prefix": "Dr.",
        "credential": "DMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2024-07-29",
        "certification_date": "2024-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1223G0001X",
            "taxonomy_group": "",
            "desc": "Dentist, General Practice",
            "state": "MI",
            "license": "2901019477",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "MI",
            "license": "2901019477",
            "primary": false
        },
        {
            "code": "1223P0700X",
            "taxonomy_group": "",
            "desc": "Dentist, Prosthodontics",
            "state": "SC",
            "license": "8593",
            "primary": false
        },
        {
            "code": "1223S0112X",
            "taxonomy_group": "",
            "desc": "Dentist, Oral and Maxillofacial Surgery",
            "state": "UT",
            "license": "12424039-9921",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Charleston, SC

Sources for this page

Verify at the official NPI Registry.