Wayne Tucker DO, PA

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

C2004133 Issued in DE

Legal business name

WAYNE TUCKER DO, PA

Practice address

100 Becks Woods Dr
Suite 202
Bear, DE 19701-3835

Phone

(302) 838-1100

Fax

(302) 838-8962

NPI assigned

Mar 27, 2007

Organization subpart

No

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

Authorized official

Name

Dr. Wayne Ira Tucker, DO, PANPI 1356430821

Title

Owner

Phone

(302) 838-1100

Specialties & licenses 2

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Enrolled in DE

Enrollment records 1

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Wayne I Tucker, D.O, P.A.

  • Family Medicine Physician
  • Bear, DE
  • NPI 1356430821
  Medicare reassignment NPD Authorized official
• Linda Forgione, NP

  • Nurse Practitioner
  • Bear, DE
  • NPI 1699893719
  NPD (past)

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

{
    "created_epoch": "1174953600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397606400000",
    "number": "1770601874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "101 BECKS WOODS DR",
            "address_2": "SUITE 100",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "19701",
            "telephone_number": "302-838-1100",
            "fax_number": "302-838-8962"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BECKS WOODS DR",
            "address_2": "SUITE 202",
            "city": "BEAR",
            "state": "DE",
            "postal_code": "197013835",
            "telephone_number": "302-838-1100",
            "fax_number": "302-838-8962"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WAYNE TUCKER DO, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-27",
        "last_updated": "2014-04-16",
        "status": "A",
        "authorized_official_last_name": "TUCKER",
        "authorized_official_first_name": "WAYNE",
        "authorized_official_middle_name": "IRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "302-838-1100",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DO, PA"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Chiropractor",
            "state": "DE",
            "license": "F1-0000484",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "DE",
            "license": "C2004133",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0001131503",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "0100579",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "1770601874",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COVENTRY",
            "identifier": "116893",
            "state": "DE"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "4331251",
            "state": "DE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jaclyn Marie Walsh, PA-C
• Erin Bree Ward, PNP
• John J Wasniewski III, DMD
• Naieshia Watson
• Todd E Watson, DC
• Charlotte Marie Weaver, RN
• Caroline Webber
• Susan Webber, RN
• Jessica Eliske Webster-Istvan, FNP-BC
• Helena Gail Webster

• Family Medicine Physician in Bear, DE
• Providers in Bear, DE by specialty
• Family Medicine Physician in Delaware

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.