Patricia Lou Tucker, ARNP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

F053221 Issued in IA

Practice address

Maternal and Women's Health
1001 E Pennsylvania Ave
Ottuma, IA 52501-2195

Phone

(641) 684-2395

Fax

(615) 684-2534

NPI assigned

Jun 8, 2005

Last updated

Jun 25, 2012By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Enrolled in IA

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

All facility ownership & control disclosures 6

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Owned or controlled facilities with NPI records 6

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Van Buren County Hospital

  • Critical Access Hospital
  • Keosauqua, IA
  • NPI 1508810714

  Corporate Director

  CMS ownership
• Van Buren County Hospital

  dba Fox River Medical Clinic

  • Rural Health Clinic/Center
  • Cantril, IA
  • NPI 1578641593

  Corporate Director

  CMS ownership
• Van Buren County Hospital

  • Medicare Defined Swing Bed Hospital Unit
  • Keosauqua, IA
  • NPI 1598844037

  Corporate Director

  CMS ownership
• Van Buren County Hospital

  dba Birmingham Medical Clinic

  • Rural Health Clinic/Center
  • Birmingham, IA
  • NPI 1790854503

  Corporate Director

  CMS ownership
• Van Buren County Hospital

  dba Keosauqua Medical Clinic

  • Rural Health Clinic/Center
  • Keosauqua, IA
  • NPI 1831260280

  Corporate Director

  CMS ownership
• Van Buren County Hospital

  dba Farmington Medical Clinic

  • Rural Health Clinic/Center
  • Farmington, IA
  • NPI 1992875678

  Corporate Director

  CMS ownership

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.

• Heartland Pathways Inc

  • Mental Health Counselor
  • Keokuk, IA
  • NPI 1053824193
  Medicare reassignment NPD

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

{
    "created_epoch": "1118188800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1340582400000",
    "number": "1770587719",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1001 PENNSYLVANIA AVE",
            "address_2": "1ST FLOOR / OTTUMA REGIONAL HEALTH CENTER",
            "city": "OTTUMWA",
            "state": "IA",
            "postal_code": "525016427",
            "telephone_number": "641-684-2395",
            "fax_number": "615-684-2534"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MATERNAL AND WOMEN'S HEALTH",
            "address_2": "1001 E PENNSYLVANIA AVE",
            "city": "OTTUMA",
            "state": "IA",
            "postal_code": "525012195",
            "telephone_number": "641-684-2395",
            "fax_number": "615-684-2534"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "PATRICIA",
        "middle_name": "LOU",
        "name_prefix": "Mrs.",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-06-08",
        "last_updated": "2012-06-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "IA",
            "license": "F053221",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLMARK",
            "identifier": "45584",
            "state": "IA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0225607",
            "state": "IA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 25, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.