Individual provider Active NPI

Sydney Alidor Tucker, CRNP

  • Gerontology Nurse Practitioner
  • Mobile, AL
National Provider Identifier
1922691856
Registry record updated Mar 23, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Gerontology Nurse PractitionerTaxonomy code 363LG0600X
License
1-153758 Issued in AL
Practice address
5955 Airport Blvd
Mobile, AL 36608-3135
Phone
(251) 633-0573
Fax
(251) 410-6079
NPI assigned
Feb 11, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 23, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1-153758 AL
Gerontology Nurse Practitioner 363LG0600X 1-153758 AL Primary

Addresses

Primary practice location

5955 Airport Blvd
Mobile, AL 36608-3135

Mailing address

PO Box 7987
Mobile, AL 36670-0987
Phone (251) 633-0573

Other practice location 1

8725 County Road 64
Daphne, AL 36526-6061
Phone (251) 625-1370

Other practice location 2

141 Tuscaloosa St
Mobile, AL 36607-3422
Phone (251) 433-3344

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20210318000396 AL Practitioner - Nurse Practitioner 1254748262 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

5955 Airport Blvd
Mobile, AL 36608-3135
Phone (251) 633-0573

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
99.38 of 100Reported as group
Promoting interoperability
96
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Certified Registered Nurse

State licenses

LicenseStateTypeSpecialty
1-153758ALMDGerontology Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Pulmonary Associates of Mobile PC Current Accepting new patients
University of Alabama Health Services Foundation, PC. CurrentSince Mar 1, 2021 Accepting new patients
Pulmonary Associates of Mobile PC CurrentSince Feb 6, 2023 Accepting new patients
Pulmonary Associates of Mobile PC PastSince Feb 6, 2023 Accepting new patients

Locations

619 19th St S
Birmingham, AL 35249

619 19th St S
Birmingham, AL 35233
Phone (205) 934-6405

1720 2nd Ave S
#422
Birmingham, AL 35294
Phone (205) 975-2767

8725 County Road 64
Daphne, AL 36526
Phone (251) 625-1370

5955 Airport Blvd
Mobile, AL 36608
Phone (251) 633-0573

141 Tuscaloosa St
Mobile, AL 36607
Phone (251) 433-3344

Organizations & group practices 4

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.

Hospital & facility affiliations 1

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": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679529600000",
    "number": "1922691856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 7987",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366700987",
            "telephone_number": "251-633-0573"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5955 AIRPORT BLVD",
            "city": "MOBILE",
            "state": "AL",
            "postal_code": "366083135",
            "telephone_number": "251-633-0573",
            "fax_number": "251-410-6079"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8725 County Road 64",
            "address_purpose": "LOCATION",
            "city": "Daphne",
            "state": "AL",
            "postal_code": "365266061",
            "country_code": "US",
            "telephone_number": "251-625-1370",
            "fax_number": "251-625-1380",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "141 Tuscaloosa St",
            "address_purpose": "LOCATION",
            "city": "Mobile",
            "state": "AL",
            "postal_code": "366073422",
            "country_code": "US",
            "telephone_number": "251-433-3344",
            "fax_number": "251-433-4052",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "SYDNEY",
        "middle_name": "ALIDOR",
        "name_prefix": "Mrs.",
        "credential": "CRNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-02-11",
        "last_updated": "2023-03-23",
        "certification_date": "2023-03-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "AL",
            "license": "1-153758",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "AL",
            "license": "1-153758",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mobile, AL

Sources for this page

Verify at the official NPI Registry.