Keelie Renee Tucker, MD

Primary specialty

Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X

License

28642 Issued in OK

Practice address

620 S Madison St
Suite 203
Enid, OK 73701-7273

Phone

(580) 213-9760

Fax

(580) 213-9769

NPI assigned

Sep 12, 2007

Last updated

Feb 12, 2018By 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 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Obstetrics/Gynecology

Education

Texas Tech University Health Science Center School of Medicine, 2007

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Women's Healthcare Associates, PLLCGroup PAC ID 5395701718, 9 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Bsa Hospital Hospital, Amarillo, TX, CCN 450231

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ktucker265686@ahs.direct-ci.com

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.

• Women's Healthcare Associates, PLLC

  • Obstetrics & Gynecology Physician
  • Amarillo, TX
  • NPI 1942239488
  Medicare reassignment Care Compare group NPD
• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  NPD (past)
• Northwest Texas Healthcare System Inc

  dba Northwest Texas Healthcare System

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1467442418
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Bsa Hospital LLC

  • General Acute Care Hospital
  • Amarillo, TX
  • NPI 1407191984
  Care Compare affiliation

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

{
    "created_epoch": "1189555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518393600000",
    "number": "1851586721",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5300 N INDEPENDENCE AVE",
            "address_2": "280",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731125556",
            "telephone_number": "580-213-9760",
            "fax_number": "580-213-9769"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "620 S MADISON ST",
            "address_2": "SUITE 203",
            "city": "ENID",
            "state": "OK",
            "postal_code": "737017273",
            "telephone_number": "580-213-9760",
            "fax_number": "580-213-9769"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KEELIE",
        "middle_name": "RENEE",
        "name_prefix": "Mrs.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-09-12",
        "last_updated": "2018-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "TX",
            "license": "P0146",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "OK",
            "license": "28642",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200345390A",
            "state": "OK"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• David B Trant, M.D.
• Hilario Trejo-Leal, BHRS
• Timothy David Trojan, MD
• Trung B Nguyen MD Inc
• Connie Jill Tucker-Smith, BS
• Quinche Tucker, LPC-CANDIDATE
• Shelby Tucker
• Nancye Turner, LPN, IBCLC
• Lori Ann Tydings
• Hilary Ugwu

• Obstetrics & Gynecology Physician in Enid, OK
• Providers in Enid, OK by specialty
• Obstetrics & Gynecology Physician in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 12, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.