Individual provider Active NPI

Kessa Tucker, D.C.

  • Chiropractor
  • Oklahoma City, OK
National Provider Identifier
1922334085
Registry record updated Dec 13, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
3959 Issued in OK
Practice address
10001 S Pennsylvania Ave
BLDG P Suite 170
Oklahoma City, OK 73159-6923
Phone
(405) 759-2345
Fax
(405) 759-3874
NPI assigned
Oct 26, 2009
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 13, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 3959 OK Primary

Addresses

Primary practice location

10001 S Pennsylvania Ave
BLDG P Suite 170
Oklahoma City, OK 73159-6923

Mailing address

PO Box 890184
Oklahoma City, OK 73189-0184
Phone (405) 759-2345

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20121030000233 OK Practitioner - Chiropractic 2365692290 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

10001 S Pennsylvania Ave
BLDG P Suite 170
Okc, OK 73159-6938
Phone (405) 759-2345

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3959OKMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Tucker Chiropractic, PLC Chiropractor CurrentSince Oct 15, 2012 Accepting new patients

Locations

10001 S Pennsylvania Ave
Ste 170
Oklahoma City, OK 73159
Phone (405) 681-2273

Organizations & group practices 1

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": "1256515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1292198400000",
    "number": "1922334085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 890184",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731890184",
            "telephone_number": "405-759-2345",
            "fax_number": "405-759-3874"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10001 S PENNSYLVANIA AVE",
            "address_2": "BLDG P SUITE 170",
            "city": "OKLAHOMA CITY",
            "state": "OK",
            "postal_code": "731596923",
            "telephone_number": "405-759-2345",
            "fax_number": "405-759-3874"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "KESSA",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-10-26",
        "last_updated": "2010-12-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "3959",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oklahoma City, OK

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 13, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.