Individual provider Active NPI

Chad Patrick Tucker, DC

  • Chiropractor
  • Desoto, TX
National Provider Identifier
1790084960
Registry record updated Jul 19, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
11607 Issued in TX
Practice address
712 N Hampton Rd
#100
Desoto, TX 75115-4500
Phone
(972) 230-8900
Fax
(972) 230-8902
NPI assigned
Mar 27, 2011
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 19, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 11607 TX Primary

Addresses

Primary practice location

712 N Hampton Rd
#100
Desoto, TX 75115-4500

Mailing address

712 N Hampton Rd
#100
Desoto, TX 75115-4500
Phone (972) 230-8900

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20110908002109 TX Practitioner - Chiropractic 0345410973 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

712 N Hampton Rd
Suite 100
Desoto, TX 75115-4530
Phone (972) 230-8900

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11607TXMDChiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Tucker Chiropractic PLLC Chiropractor CurrentSince Jul 20, 2011 Accepting new patients

Locations

712 N Hampton Rd
Ste 100
Desoto, TX 75115
Phone (972) 223-1111

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1301184000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1311033600000",
    "number": "1790084960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "712 N HAMPTON RD",
            "address_2": "#100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154500",
            "telephone_number": "972-230-8900",
            "fax_number": "972-230-8902"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "712 N HAMPTON RD",
            "address_2": "#100",
            "city": "DESOTO",
            "state": "TX",
            "postal_code": "751154500",
            "telephone_number": "972-230-8900",
            "fax_number": "972-230-8902"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHAD",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "DC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2011-03-27",
        "last_updated": "2011-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "11607",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Desoto, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.