Individual provider Active NPI

Megan Nicole Tucker, PMHNP-BC; MSN

  • Psychiatric/Mental Health Nurse Practitioner
  • Scottsville, KY
National Provider Identifier
1730401647
Registry record updated Mar 4, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
4010680 Issued in KY
Practice address
165 Crossridge LN
Scottsville, KY 42164-8377
Phone
(270) 784-9464
NPI assigned
Feb 18, 2010
Last updated
Mar 4, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 4, 2024

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 4010680 KY Primary
Registered Nurse 163W00000X 1140618 KY
Massage Therapist 225700000X KY-3478 KY

Addresses

Primary practice location

165 Crossridge LN
Scottsville, KY 42164-8377

Mailing address

165 Crossridge LN
Scottsville, KY 42164-8377
Phone (270) 784-9464

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20240326002727 KY Practitioner - Nurse Practitioner 9335586908 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices

Practice addresses (Care Compare)

350 Park St
Suite 204
Bowling Green, KY 42101-1784
Phone (270) 843-5103

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
KY-3478KYMDMassage Therapist
4010680KYMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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 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": "1266451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1709510400000",
    "number": "1730401647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "165 CROSSRIDGE LN",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421648377",
            "telephone_number": "270-784-9464"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 CROSSRIDGE LN",
            "city": "SCOTTSVILLE",
            "state": "KY",
            "postal_code": "421648377",
            "telephone_number": "270-784-9464"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "MEGAN",
        "middle_name": "NICOLE",
        "credential": "PMHNP-BC; MSN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-02-18",
        "last_updated": "2024-03-04",
        "certification_date": "2024-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "4010680",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1140618",
            "primary": false
        },
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "KY-3478",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Scottsville, KY

Sources for this page

Verify at the official NPI Registry.