Individual provider Active NPI

Annell Tucker

  • Podiatric Clinic/Center
  • Montgomery, AL
National Provider Identifier
1669784971
Registry record updated Jul 2, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Podiatric Clinic/CenterTaxonomy code 261QP1100X
Practice address
215 Perry Hill Rd
115-S
Montgomery, AL 36109-3725
Phone
(334) 272-4670
NPI assigned
Jul 2, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 2, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Podiatric Clinic/Center 261QP1100X Primary

Addresses

Primary practice location

215 Perry Hill Rd
115-S
Montgomery, AL 36109-3725

Mailing address

215 Perry Hill Rd
115-S
Montgomery, AL 36109-3725
Phone (334) 272-4670

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20130515000491 IL Practitioner - Podiatry 5991942781 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Podiatry
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Vitae Health Medical Illinois, PLLCGroup PAC ID 2365798410, 214 clinicians

Practice addresses (Care Compare)

1601 N Western Ave
Park Ridge, IL 60068-1233
Phone (847) 825-5531

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue1-10
Removal of nail tissue1567
Removal or shaving of skin growth627

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Excellent Medical Associates, P.C. CurrentSince Nov 1, 2015 Accepting new patients
Alqaim Medical Associates Inc CurrentSince Jun 17, 2026 Accepting new patients
Vitae Health Medical Illinois, PLLC CurrentSince Dec 1, 2023 Accepting new patients

Locations

303 E Wacker Dr
Ste 1127
Chicago, IL 60601
Phone (312) 328-2347

10300 Southwest Hwy
Chicago Ridge, IL 60415
Phone (708) 425-1100

701 N La Grange Rd
La Grange Pk, IL 60526
Phone (708) 681-3200

14489 John Humphrey Dr
#1
Orland Park, IL 60462
Phone (708) 364-1205

11860 Southwest Hwy
Palos Heights, IL 60463
Phone (630) 286-4000

1601 N Western Ave
Park Ridge, IL 60068
Phone (773) 960-1163

3450 Oakton St
Ste 300
Skokie, IL 60076

Organizations & group practices 3

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": "1278028800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1278028800000",
    "number": "1669784971",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "215 PERRY HILL RD",
            "address_2": "115-S",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361093725",
            "telephone_number": "334-272-4670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "215 PERRY HILL RD",
            "address_2": "115-S",
            "city": "MONTGOMERY",
            "state": "AL",
            "postal_code": "361093725",
            "telephone_number": "334-272-4670"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "ANNELL",
        "name_prefix": "Dr.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-02",
        "last_updated": "2010-07-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "261QP1100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Podiatric",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Montgomery, AL

Sources for this page

Verify at the official NPI Registry.