Individual provider Active NPI

Levi Jacob Tucker, FNP-C

  • Nurse Practitioner
  • Coffeyville, KS
National Provider Identifier
1699532242
Registry record updated Apr 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5381178091 Issued in KS
Practice address
801 W 8TH St
Coffeyville, KS 67337-4109
Phone
(620) 251-4300
NPI assigned
Feb 29, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5381178091 KS Primary

Addresses

Primary practice location

801 W 8TH St
Coffeyville, KS 67337-4109

Mailing address

PO Box 1832
Pittsburg, KS 66762-1832
Phone (888) 777-9170

Other practice location 1

3751 W Main St
Independence, KS 67301-8446
Phone (620) 577-2131

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KS
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
I20240509001039 KS Practitioner - Nurse Practitioner 7416398300 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Health Center of Southeast Kansas IncGroup PAC ID 7911816392, 111 clinicians

Practice addresses (Care Compare)

801 W 8TH St
Coffeyville, KS 67337-4109
Phone (620) 251-4300

Hospital & facility affiliations

  • Coffeyville Regional Medical Center, Inc Hospital, Coffeyville, KS, CCN 171387

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5381178091KSMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Community Health Center of Southeast Kansas Inc Current Accepting new patients
Community Health Center of Southeast Kansas Inc CurrentSince May 20, 2024 Accepting new patients
Community Health Center of Southeast Kansas, Inc CurrentSince May 20, 2024 Accepting new patients
Community Health Center of Southeast Kansas, Inc Past Accepting new patients

Locations

601 E Washington St
Arma, KS 66712
Phone (620) 347-4033

2990 Military Ave
Baxter Springs, KS 66713
Phone (620) 856-2900

100 N Military Ave
Baxter Springs, KS 66713

801 W 8th St
Coffeyville, KS 67337
Phone (620) 251-4300

1110 W 8th St
Coffeyville, KS 67337
Phone (620) 252-1798

124 S Highschool Ave
Columbus, KS 66725

101 W Sycamore St
Columbus, KS 66725
Phone (620) 429-2101

2322 S Main St
Fort Scott, KS 66701
Phone (620) 223-0135

312 S Maple St
Garnett, KS 66032
Phone (785) 448-6988

1216 Hawaii Rd
Humboldt, KS 66748
Phone (620) 473-1002

3354 Highway 160
Independence, KS 67301
Phone (620) 331-1260

203 N Kentucky St
Iola, KS 66749

1017 E Market St
Lacygne, KS 66040
Phone (913) 757-4575

302 N 1st St
Mound City, KS 66056
Phone (913) 795-2203

2100 Commerce Dr
Parsons, KS 67357
Phone (620) 421-2159

924 N Broadway St
Pittsburg, KS 66762
Phone (620) 231-6788

1978 E 4th St
Pittsburg, KS 66762
Phone (620) 670-3896

1011 S Mount Carmel Pl
Pittsburg, KS 66762
Phone (620) 231-6160

3011 N Michigan St
Pittsburg, KS 66762
Phone (620) 231-1960

11155 Tucker Rd
Pleasanton, KS 66075
Phone (913) 347-8110

Interoperability endpoints

  • Direct secure messaging: levi.tucker@chcsek.eclinicaldirectplus.com

Organizations & group practices 4

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 1

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713916800000",
    "number": "1699532242",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1832",
            "city": "PITTSBURG",
            "state": "KS",
            "postal_code": "667621832",
            "telephone_number": "888-777-9170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "801 W 8TH ST",
            "city": "COFFEYVILLE",
            "state": "KS",
            "postal_code": "673374109",
            "telephone_number": "620-251-4300"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3751 W Main St",
            "address_purpose": "LOCATION",
            "city": "Independence",
            "state": "KS",
            "postal_code": "673018446",
            "country_code": "US",
            "telephone_number": "620-577-2131",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "LEVI",
        "middle_name": "JACOB",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-02-29",
        "last_updated": "2024-04-24",
        "certification_date": "2024-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KS",
            "license": "5381178091",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Coffeyville, KS

Sources for this page

Verify at the official NPI Registry.