Individual provider Active NPI

Chandler Tucker

  • Metabolic Nutrition Registered Dietitian
  • Boulder, CO
National Provider Identifier
1952127540
Registry record updated Nov 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Metabolic Nutrition Registered DietitianTaxonomy code 133VN1006X
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

Updated by the provider on Nov 27, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
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, AR5 enrollments

Enrollment records 5

Enrollment IDStateProvider typePAC IDDetails
I20250924004298 CO Practitioner - Registered Dietitian Or Nutrition Professional 8729583323 Reassigns benefits to 1 organization
I20250925000303 NJ Practitioner - Registered Dietitian Or Nutrition Professional 8729583323 Reassigns benefits to 1 organization
I20250925000495 DC Practitioner - Registered Dietitian Or Nutrition Professional 8729583323 Reassigns benefits to 1 organization
I20250926003950 AZ Practitioner - Registered Dietitian Or Nutrition Professional 8729583323 Reassigns benefits to 1 organization
I20251028003263 AR Practitioner - Registered Dietitian Or Nutrition Professional 8729583323 Reassigns benefits to 1 organization

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

LicenseStateTypeSpecialty
2911ARMDEndodontist

Practice roles

OrganizationSpecialtyStatusNew patients
Season Clinical Care NJ PC CurrentSince Sep 1, 2025 Accepting new patients
H-E-B, LP PastSince Sep 1, 2025 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.

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.

Verify at the official NPI Registry.