Active NPI
Demetric Antron Tuggle
- Driver
- Douglasville, GA
National Provider Identifier
1801540273
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Driver
- License
- 040114469
- Practice address
- 3480 Hearthstone PL
Douglasville, GA 30135-7286 - Phone
- (470) 754-5144
- NPI assigned
- Feb 4, 2022
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Driver | 172A00000X | 040114469 | GA | Primary |
Addresses
Primary practice location
3480 Hearthstone PL
Douglasville, GA 30135-7286
Mailing address
3480 Hearthstone PL
Douglasville, GA 30135-7286
Phone (470) 754-5144
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 040114469 | GA | MD | Driver |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1643932800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1643932800000",
"number": "1801540273",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3480 HEARTHSTONE PL",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301357286",
"telephone_number": "470-754-5144"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3480 HEARTHSTONE PL",
"city": "DOUGLASVILLE",
"state": "GA",
"postal_code": "301357286",
"telephone_number": "470-754-5144"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUGGLE",
"first_name": "DEMETRIC",
"middle_name": "ANTRON",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2022-02-04",
"last_updated": "2022-02-04",
"certification_date": "2022-02-04",
"status": "A"
},
"taxonomies": [
{
"code": "172A00000X",
"taxonomy_group": "",
"desc": "Driver",
"state": "GA",
"license": "040114469",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Douglasville, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.