Individual provider Active NPI

John William Tucker, PA

  • Medical Physician Assistant
  • Hayesville, NC
National Provider Identifier
1669453882
Registry record updated May 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Medical Physician AssistantTaxonomy code 363AM0700X
License
102348 Issued in NC
Practice address
241 Church St
Hayesville, NC 28904-9688
Phone
(828) 389-6383
Fax
(828) 389-2322
NPI assigned
Nov 7, 2005
Last updated
May 16, 2013By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Medical Physician Assistant 363AM0700X 102348 NC Primary

Addresses

Primary practice location

241 Church St
Hayesville, NC 28904-9688

Mailing address

PO Box 1309
Hayesville, NC 28904-1309
Phone (828) 389-6383

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20040720001462 NC Practitioner - Physician Assistant 0749260917 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2005
Medicare assignment
May accept Medicare assignment
Group practices
Ben Gans Family MedicineGroup PAC ID 6800334988, 2 clinicians

Practice addresses (Care Compare)

200 Slope St
Bryson City, NC 28713-0970
Phone (828) 736-8548

PO Box
Suite 976
Bryson City, NC 28713-0976

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
102348NCMDRegistered Nurse

Practice roles

OrganizationSpecialtyStatusNew patients
Smoky Mountain Urgent Care PC CurrentSince Feb 14, 2015 Accepting new patients
Smoky Mountain Urgent Care PC CurrentSince Feb 14, 2015 Accepting new patients
Macon Family Medical Care, PLLC Past Accepting new patients
Clay Comprehensive Health Services, Inc. Past Accepting new patients
Phoenix Emergency Services of Murphy PLLC Past Accepting new patients

Locations

120 Veterans Blvd
Bryson City, NC 28713
Phone (828) 488-1974

80 Veterans Blvd
Bryson City, NC 28713
Phone (828) 538-4546

195 Franklin Plz
Franklin, NC 28734
Phone (828) 369-4427

Organizations & group practices 6

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.

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": "1131321600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1368662400000",
    "number": "1669453882",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1309",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289041309",
            "telephone_number": "828-389-6383",
            "fax_number": "828-389-2322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "241 CHURCH ST",
            "city": "HAYESVILLE",
            "state": "NC",
            "postal_code": "289049688",
            "telephone_number": "828-389-6383",
            "fax_number": "828-389-2322"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JOHN",
        "middle_name": "WILLIAM",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-07",
        "last_updated": "2013-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "NC",
            "license": "102348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hayesville, NC

Sources for this page

Verify at the official NPI Registry.