Individual provider Active NPI

Kristen Sieber Tucker, PT

  • Physical Therapist
  • Chapel Hill, NC
National Provider Identifier
1881064723
Registry record updated Oct 12, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
P16618 Issued in NC
Practice address
205 Sage Rd
Ste 203
Chapel Hill, NC 27514-6995
Phone
(919) 918-4171
NPI assigned
Oct 5, 2015
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X P16618 NC Primary

Addresses

Primary practice location

205 Sage Rd
Ste 203
Chapel Hill, NC 27514-6995

Mailing address

790 Remington Blvd
Bolingbrook, IL 60440-4909
Phone (630) 296-2223

Other names 1

  • Kristen Marie Sieber Former name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170330000623 NC Practitioner - Physical Therapist in Private Practice 5294045084 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P16618NCMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Proaxis Therapy NC, LLC Physical Therapist CurrentSince Dec 5, 2016 Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Proaxis Therapy SC, LLC Physical Therapist Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients
Carolina Physical Therapy Associates LLC Physical Therapist Past Accepting new patients
Carolina Physical Therapy Associates LLC Past Accepting new patients

Locations

33202 Collection Ctr Dr
Chicago, IL 60693

303 Park St
Belmont, NC 28012
Phone (704) 826-9980

205 Sage Rd
Ste 203
Chapel Hill, NC 27514
Phone (919) 918-4171

Organizations & group practices 9

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.

NPI Registry JSON

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

{
    "created_epoch": "1444003200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1539302400000",
    "number": "1881064723",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 REMINGTON BLVD",
            "city": "BOLINGBROOK",
            "state": "IL",
            "postal_code": "604404909",
            "telephone_number": "630-296-2223",
            "fax_number": "630-759-9510"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "205 SAGE RD",
            "address_2": "STE 203",
            "city": "CHAPEL HILL",
            "state": "NC",
            "postal_code": "275146995",
            "telephone_number": "919-918-4171"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KRISTEN",
        "middle_name": "SIEBER",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-10-05",
        "last_updated": "2018-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P16618",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KRISTEN",
            "last_name": "SIEBER",
            "middle_name": "MARIE",
            "credential": "PT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Chapel Hill, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 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.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.