Harold Wayne Duckett

Primary specialty

ProsthetistTaxonomy code 224P00000X

License

006054891 Issued in IL

Practice address

1801 15TH Street PL
Moline, IL 61265-3964

Phone

(309) 764-4477

NPI assigned

Mar 31, 2020

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1585612800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585612800000",
    "number": "1700414950",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1801 15TH STREET PL",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653964",
            "telephone_number": "309-764-4477"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1801 15TH STREET PL",
            "city": "MOLINE",
            "state": "IL",
            "postal_code": "612653964",
            "telephone_number": "309-764-4477"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DUCKETT",
        "first_name": "HAROLD",
        "middle_name": "WAYNE",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-03-31",
        "last_updated": "2020-03-31",
        "certification_date": "2020-03-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Prosthetist",
            "state": "IL",
            "license": "006054891",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Stephen Mark Draminski, L.C.P.C.
• Rebecca Marie Drehman, APRN
• Leslie Drenth, PT
• Laura Driscoll, MA
• Michael Dubois
• Joanna Marie Duffy, CD(DONA),CLC,CPST
• Patricia Dunbar, M.D.
• Laura C Duncan, OT
• Shawn Kurtis Duncan, D.C.
• Emma Durbin, RBT

• Prosthetist in Moline, IL
• Providers in Moline, IL by specialty
• Prosthetist in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.