James L Tucker, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PY9444 Issued in FL

Practice address

124 E Miracle Strip Pkwy
Suite 302
Mary Esther, FL 32569-1988

Phone

(850) 243-8086

Fax

(850) 243-2702

NPI assigned

Jan 16, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1168905600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1454025600000",
    "number": "1700937638",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "124 E MIRACLE STRIP PKWY",
            "address_2": "SUITE 302",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691988",
            "telephone_number": "850-243-8086",
            "fax_number": "850-243-2702"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "124 E MIRACLE STRIP PKWY",
            "address_2": "SUITE 302",
            "city": "MARY ESTHER",
            "state": "FL",
            "postal_code": "325691988",
            "telephone_number": "850-243-8086",
            "fax_number": "850-243-2702"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JAMES",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-16",
        "last_updated": "2016-01-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "CO",
            "license": "732",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "CO",
            "license": "732",
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "FL",
            "license": "PY9444",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE GROUP",
            "identifier": "K3215",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Hope D Traylor, LMT
• Jennifer M Trendt, DC
• Halee Tymon, BCBA
• Martha Lawson Van Dam, M.S., NCC
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• Allison E. Vinson, LCSW
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• Clinical Psychologist in Mary Esther, FL
• Providers in Mary Esther, FL by specialty
• Clinical Psychologist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2016; 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.