Individual provider Active NPI

Morgan Nicole Tucker, PA-C

  • Physician Assistant
  • Lewisville, NC
National Provider Identifier
1720572084
Registry record updated Jun 20, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
Practice address
6630 Shallowford Rd
Lewisville, NC 27023-9504
Phone
(336) 945-2080
NPI assigned
Jun 20, 2018
Last updated
Jun 20, 2018By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 20, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X Primary

Addresses

Primary practice location

6630 Shallowford Rd
Lewisville, NC 27023-9504

Mailing address

431 Park Ridge LN Apt G
Winston Salem, NC 27104-3563
Phone (704) 883-6286

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
I20180904003006 NC Practitioner - Physician Assistant 2264782770 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest University Health Sciences CurrentSince Aug 13, 2018 Accepting new patients
Wake Forest Health Network, LLC CurrentSince Dec 27, 2022 Accepting new patients
Cornerstone Health Care, LLC CurrentSince Dec 27, 2022 Accepting new patients

Locations

1814 Westchester Dr
Ste 302
High Point, NC 27262
Phone (336) 802-2170

905 Phillips Ave
High Point, NC 27262
Phone (336) 802-2040

6630 Shallowford Rd
Lewisville, NC 27023
Phone (336) 716-3155

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: mtucker2755581@carolinashealthcaresystem.direct-ci.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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 5

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": "1529452800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1529452800000",
    "number": "1720572084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "431 PARK RIDGE LN APT G",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271043563",
            "telephone_number": "704-883-6286"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6630 SHALLOWFORD RD",
            "city": "LEWISVILLE",
            "state": "NC",
            "postal_code": "270239504",
            "telephone_number": "336-945-2080"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MORGAN",
        "middle_name": "NICOLE",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-06-20",
        "last_updated": "2018-06-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lewisville, NC

Sources for this page

Verify at the official NPI Registry.