NPIMap

Individual provider Active NPI

James Edwin Tucker, DO

  • Family Medicine Physician
  • Hannibal, MO
National Provider Identifier
1851772289
Registry record updated Jul 3, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
2016033286 Issued in MO
Practice address
6500 Hospital Dr
Hannibal, MO 63401
Phone
(573) 629-3440
Fax
(573) 629-3423
NPI assigned
Jun 11, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 3, 2018

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 2015017297 MO
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 2016033286 MO Primary

Addresses

Primary practice location

6500 Hospital Dr
Hannibal, MO 63401

Mailing address

PO Box 1239
Hannibal, MO 63401-1239
Phone (573) 629-3440

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MO
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180803002064 MO Practitioner - Family Practice 9335451954 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
At Still University of Health Sciences, College of Osteo Med, Kirksville, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hannibal Regional Healthcare System Inc 256 clinicians

Practice addresses (Care Compare)

6500 Hospital Dr
Hannibal, MO 63401-6890
Phone (573) 248-1300

Hospital & facility affiliations

  • Hannibal Regional Hospital Home Health Agency Home health agency, Hannibal, MO, CCN 267282
  • Community Loving Care Hospice Hospice, Wentzville, MO, CCN 261594
  • St. Croix Hospice Hospice, Moberly, MO, CCN 261570
  • Hannibal Regional Hospital Hospital, Hannibal, MO, CCN 260025
  • Blessing Hospital Hospital, Quincy, IL, CCN 140015
  • University of Missouri Health Care Hospital, Columbia, MO, CCN 260141
  • Hannibal Regional Healthcare System Inpatient rehabilitation facility, Hannibal, MO, CCN 26T025
  • Luther Manor Retirement & Nursing Center Nursing home, Hannibal, MO, CCN 265690

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
2015017297MOMDFamily Medicine Physician
2016033286MOMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Hannibal Regional Healthcare System, Inc Multi-Specialty CurrentSince Jul 9, 2018 Accepting new patients
Hannibal Regional Healthcare System Inc Multi-Specialty CurrentSince Jul 9, 2018 Accepting new patients
Luther Manor Association Past Accepting new patients
Hannibal Regional Healthcare System, Inc Family Medicine Past Accepting new patients
Hannibal Regional Healthcare System, Inc Past Accepting new patients

Locations

6500 Hospital Dr
Ste 2A
Hannibal, MO 63401
Phone (573) 629-3400

6500 Hospital Dr
Hannibal, MO 63401
Phone (573) 629-3400

Interoperability endpoints

  • Direct secure messaging: jamestucker@hrmg.allscriptsdirect.net
  • FHIR API: https://fhir.fhirpoint.open.allscripts.com/fhirroute/open/10040602

Organizations & group practices 18

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.

View all 18

Hospital & facility affiliations 10

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

NPI Registry JSON

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

{
    "created_epoch": "1433980800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1530576000000",
    "number": "1851772289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1239",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "634011239",
            "telephone_number": "573-629-3440",
            "fax_number": "573-629-3423"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6500 HOSPITAL DR",
            "city": "HANNIBAL",
            "state": "MO",
            "postal_code": "63401",
            "telephone_number": "573-629-3440",
            "fax_number": "573-629-3423"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "JAMES",
        "middle_name": "EDWIN",
        "credential": "DO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-06-11",
        "last_updated": "2018-07-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2015017297",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "MO",
            "license": "2016033286",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hannibal, MO

Sources for this page

Verify at the official NPI Registry.