Individual provider Active NPI

Kathryn Ashleigh Tucker, FNP-C

  • Family Nurse Practitioner
  • Colleyville, TX
National Provider Identifier
1881310944
Registry record updated Oct 19, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
1076104 Issued in TX
Practice address
6515 Colleyville Blvd
Colleyville, TX 76034-6231
Phone
(817) 424-3774
NPI assigned
Oct 19, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 1076104 TX Primary

Addresses

Primary practice location

6515 Colleyville Blvd
Colleyville, TX 76034-6231

Mailing address

929 Chastien CT
Fort Worth, TX 76131-4530
Phone (817) 980-4536

Medicare participation

Medicare enrollment files
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: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20241106004163 TX Practitioner - Nurse Practitioner 6305370859 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
MedhealthGroup PAC ID 9931001567, 435 clinicians

Practice addresses (Care Compare)

3055 W Southlake Blvd
Suite 100
Southlake, TX 76092-6730
Phone (682) 593-7639

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1076104TXMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Medhealth CurrentSince Oct 25, 2024 Accepting new patients
Medhealth CurrentSince Oct 25, 2024 Accepting new patients
Advanced Pain & Rehabilitation Association PLLC Past Accepting new patients

Locations

6515 Colleyville Blvd
Colleyville, TX 76034
Phone (682) 593-7639

5224 S State Highway 360
Grand Prairie, TX 75052
Phone (972) 522-0691

3055 W Southlake Blvd
Ste 100
Southlake, TX 76092
Phone (682) 593-7639

613 S Highway 78
Wylie, TX 75098
Phone (972) 941-8700

Interoperability endpoints

  • Direct secure messaging: ktucker264660@dm.mhd.com

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1666137600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1666137600000",
    "number": "1881310944",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "929 CHASTIEN CT",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761314530",
            "telephone_number": "817-980-4536"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6515 COLLEYVILLE BLVD",
            "city": "COLLEYVILLE",
            "state": "TX",
            "postal_code": "760346231",
            "telephone_number": "817-424-3774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KATHRYN",
        "middle_name": "ASHLEIGH",
        "name_prefix": "Mrs.",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-19",
        "last_updated": "2022-10-19",
        "certification_date": "2022-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "TX",
            "license": "1076104",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Colleyville, TX

Sources for this page

Verify at the official NPI Registry.