Bethany Jeannine Tucker, NURSE PRACTITIONER

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

1-145278 Issued in AL

Practice address

180 Medical St
Snead, AL 35952-6468

Phone

(205) 386-4341

NPI assigned

Aug 3, 2021

Last updated

Aug 3, 2021By 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 1

Addresses

Other names 1

• Bethany Jeannine Tucker Former name

Medicare fee-for-service enrollment

Enrolled in AL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Gana Holdings, LLC

  dba United Doctors Family Medical Center - Snead

  • Internal Medicine Physician
  • Snead, AL
  • NPI 1396375267
  Medicare reassignment NPD

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

{
    "created_epoch": "1627948800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1627948800000",
    "number": "1881368934",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "180 MEDICAL ST",
            "city": "SNEAD",
            "state": "AL",
            "postal_code": "359526468",
            "telephone_number": "205-386-4341"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "180 MEDICAL ST",
            "city": "SNEAD",
            "state": "AL",
            "postal_code": "359526468",
            "telephone_number": "205-386-4341"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BETHANY",
        "middle_name": "JEANNINE",
        "credential": "NURSE PRACTITIONER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-08-03",
        "last_updated": "2021-08-03",
        "certification_date": "2021-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "AL",
            "license": "1-145278",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "BETHANY",
            "last_name": "TUCKER",
            "middle_name": "JEANNINE",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Kelly S Knowles, RPT
• Lauren Loveless, CRNP
• Patriot Dental Snead LLC (Kenneth Luckie Vandervoort DMD)
• Branden D Sims, CRNP
• David L Skees, D.M.D
• Wal-Mart Stores East LP (Walmart Pharmacy 10-2260)

• Family Nurse Practitioner in Snead, AL
• Providers in Snead, AL by specialty
• Family Nurse Practitioner in Alabama

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2021; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.