Active NPI
Chandler Tucker
- Metabolic Nutrition Registered Dietitian
- Boulder, CO
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Metabolic Nutrition Registered Dietitian
- License
- 86167596
- Practice address
- 1190 Lehigh St
Boulder, CO 80305-6351 - Phone
- (603) 315-9565
- NPI assigned
- Nov 27, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Metabolic Nutrition Registered Dietitian | 133VN1006X | 86167596 | Primary |
Addresses
Primary practice location
1190 Lehigh St
Boulder, CO 80305-6351
Mailing address
1190 Lehigh St
Boulder, CO 80305-6351
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in CO, NJ, DC, AZ, AR
Enrollment records 5
Care Compare profile
Medicare Care Compare- Specialty
- Registered Dietitian Or Nutrition Professional
- Education
- Other, 2018
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
1710 Keller Pkwy
Suite 6565
Keller, TX 76248-3749
482 Pine Glade Rd
Nederland, CO 80466-9630
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 2911 | AR | MD | Endodontist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Season Clinical Care NJ PC | Current | Accepting new patients | |
| H-E-B, LP | Past | Accepting new patients | |
| Becky Cohen Nutrition, LLC | Nutrition, Metabolic | Past | Accepting new patients |
Locations
1719 Highway 10
Parsippany, NJ 07054
1719 Highway 10
Ste 300
Parsippany, NJ 07054
6565 N MacArthur Blvd
Ste 225
Irving, TX 75039
Phone (972) 635-0489
1710 Keller Pkwy
Keller, TX 76248
Phone (210) 201-2364
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.
-
- Registered Dietitian
- Parsippany, NJ
- NPI 1700693348
-
- Community/Retail Pharmacy
- Austin, TX
- NPI 1073622411
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1732665600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1732665600000",
"number": "1952127540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1190 LEHIGH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803056351"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1190 LEHIGH ST",
"city": "BOULDER",
"state": "CO",
"postal_code": "803056351",
"telephone_number": "603-315-9565"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TUCKER",
"first_name": "CHANDLER",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-11-27",
"last_updated": "2024-11-27",
"certification_date": "2024-11-26",
"status": "A"
},
"taxonomies": [
{
"code": "133VN1006X",
"taxonomy_group": "",
"desc": "Dietitian, Registered, Nutrition, Metabolic",
"state": null,
"license": "86167596",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Boulder, CO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 27, 2024; 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.