Individual provider Active NPI

Krista Tucker

  • Family Nurse Practitioner
  • Northport, AL
National Provider Identifier
1669065736
Registry record updated Feb 18, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1-131356 Issued in AL
Practice address
4401 Watermelon Rd
Northport, AL 35473-5197
Phone
(205) 343-2811
Fax
(205) 391-0900
NPI assigned
Feb 18, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1-131356 AL Primary

Addresses

Primary practice location

4401 Watermelon Rd
Northport, AL 35473-5197

Mailing address

4401 Watermelon Rd
Northport, AL 35473-5197
Phone (205) 343-2811

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AL
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

Enrollment IDStateProvider typePAC IDDetails
I20210326000190 AL Practitioner - Nurse Practitioner 3072920644 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Cardiology Associates of West Alabama, PCGroup PAC ID 5193704351, 4 clinicians

Practice addresses (Care Compare)

4401 Watermelon Rd
Northport, AL 35473-5197
Phone (205) 343-2811

Hospital & facility affiliations

  • DCH Regional Medical Center Hospital, Tuscaloosa, AL, CCN 010092

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

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.

Hospital & facility affiliations 3

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

NPI Registry JSON

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

{
    "created_epoch": "1613606400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613606400000",
    "number": "1669065736",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4401 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735197",
            "telephone_number": "205-343-2811",
            "fax_number": "205-391-0900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4401 WATERMELON RD",
            "city": "NORTHPORT",
            "state": "AL",
            "postal_code": "354735197",
            "telephone_number": "205-343-2811",
            "fax_number": "205-391-0900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KRISTA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-18",
        "last_updated": "2021-02-18",
        "certification_date": "2021-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-131356",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Northport, AL

Sources for this page

Verify at the official NPI Registry.