Charles Thomas Tucker, MD

Primary specialty

Nephrology PhysicianTaxonomy code 207RN0300X

License

026402 Issued in GA

Practice address

111 Colonial Way Ste 2
Jesup, GA 31545-0132

Phone

(912) 588-1919

Fax

(912) 588-1919

NPI assigned

Aug 21, 2006

Last updated

Sep 29, 2026By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 5

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Brunswick Urgent Care, LLC

  • Family Nurse Practitioner
  • Brunswick, GA
  • NPI 1023571411
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790640000000",
    "number": "1831204478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 SCRANTON CONNECTOR",
            "address_2": "SUITE 117",
            "city": "BRUNSWICK",
            "state": "GA",
            "postal_code": "315250559",
            "telephone_number": "912-264-5961",
            "fax_number": "912-262-9499"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 COLONIAL WAY STE 2",
            "city": "JESUP",
            "state": "GA",
            "postal_code": "315450132",
            "telephone_number": "912-588-1919",
            "fax_number": "912-588-1919"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 Scranton Connector",
            "address_2": "Suite 117",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315250559",
            "country_code": "US",
            "telephone_number": "912-264-5961",
            "fax_number": "912-262-9499",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3025 Shrine Rd Ste 450",
            "address_purpose": "LOCATION",
            "city": "Brunswick",
            "state": "GA",
            "postal_code": "315204787",
            "country_code": "US",
            "telephone_number": "912-264-6133",
            "fax_number": "912-267-1415",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "CHARLES",
        "middle_name": "THOMAS",
        "name_prefix": "Mr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-21",
        "last_updated": "2026-09-29",
        "certification_date": "2020-01-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RN0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Nephrology",
            "state": "GA",
            "license": "026402",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "390004393",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "WELLCARE",
            "identifier": "N363398",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERIGROUP",
            "identifier": "01035667",
            "state": "GA"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "000291079A",
            "state": "GA"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE SHIELD",
            "identifier": "616370",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Tim's Home Medical LLC
• Chance Stewart Tiner, NP
• Town and Country Pharmacy
• Kevin Anthony Trankle, CRNA
• Terese Truax
• Derek William Tucker
• Heather F Tyre, PA-C
• Leslie Brook Tzen, NP
• Unihealth Solutions of North Georgia, Inc. (UniHealth SOURCE of Jesup)
• John Matthew Valosen, M.D.

• Nephrology Physician in Jesup, GA
• Providers in Jesup, GA by specialty
• Nephrology Physician in Georgia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 29, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.