Davis Tucker

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

P20151 Issued in NC

Practice address

3787 Shipyard Blvd
Wilmington, NC 28403-6148

Phone

(910) 332-3800

Fax

(910) 251-0421

NPI assigned

Apr 5, 2021

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2020

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Change the Game Performance Therapy IncGroup PAC ID 6406380203, 6 clinicians

Practice addresses (Care Compare)

Merit-based Incentive Payment System (MIPS)

Final score

89.07 of 100Reported as group

Quality

85.94

Promoting interoperability

100

Improvement activities

40

Cost

77.63

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 and National Provider Directory roles.

• Change the Game Performance Therapy, Inc.

  • Physical Therapy Clinic/Center
  • Wilmington, NC
  • NPI 1659141703

  Physical Therapist

  Medicare reassignment Care Compare group NPD
• Emergeortho PA

  • Orthopaedic Surgery Physician
  • Durham, NC
  • NPI 1376592964

  Physical Therapist

  Medicare reassignment NPD
• Emergeortho PA

  • Durable Medical Equipment & Medical Supplies
  • Eden, NC
  • NPI 1841170222
  NPD

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

{
    "created_epoch": "1617580800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1617580800000",
    "number": "1962081315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3787 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036148",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3787 SHIPYARD BLVD",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284036148",
            "telephone_number": "910-332-3800",
            "fax_number": "910-251-0421"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "DAVIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-04-05",
        "last_updated": "2021-04-05",
        "certification_date": "2021-04-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NC",
            "license": "P20151",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Irving Louis Trust, R.PH.
• Jill Tschekunow, MS, CCC-SLP
• John Tsung-Long Tseng, MD
• Tawny Tseng, FNP, PMHNP
• Tsi of Wilmington, LLC
• Ellen Jane Tucker, MSW
• Holly Ann Tucker, D.C.
• Lindsay Jan Tucker, RBT
• Victoria Tucker, N.P.
• Mary Alexis Tully, PA-C

• Physical Therapist in Wilmington, NC
• Providers in Wilmington, NC by specialty
• Physical Therapist in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 5, 2021; 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.