Bronya Kay Tucker, NP-C

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

50676 Issued in WV

Practice address

1325 Locust Ave
Fairmont, WV 26554-1435

Phone

(304) 367-7100

NPI assigned

Apr 2, 2009

Sex

Female

Sole proprietor

No

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

Specialties & licenses 3

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

Practice roles

Interoperability endpoints

• Direct secure messaging: bronya.tucker@mvahealth.directbygreenway.com

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.

• Pursuecare New Jersey PC

  • Addiction (Substance Use Disorder) Counselor
  • Voorhees, NJ
  • NPI 1851067524

  Psychiatric/Mental Health

  NPD (past)

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

{
    "created_epoch": "1238630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605657600000",
    "number": "1972745156",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1615",
            "city": "MORGANTOWN",
            "state": "WV",
            "postal_code": "265071615",
            "telephone_number": "304-285-3679",
            "fax_number": "304-285-3694"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1325 LOCUST AVE",
            "city": "FAIRMONT",
            "state": "WV",
            "postal_code": "265541435",
            "telephone_number": "304-367-7100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "BRONYA",
        "middle_name": "KAY",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-04-02",
        "last_updated": "2020-11-18",
        "certification_date": "2020-11-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "WV",
            "license": "50676",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "WV",
            "license": "50676",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WV",
            "license": "50676",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSE",
            "identifier": "50676",
            "state": "WV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Kayleann Marie Travis
• Michele Marie Triantifilou
• Joseph Triplett
• Destiny Truman
• Angel Tucker
• Kenneth Tucker
• Aaliyah Turner
• Felicia Renee Turner, LPC
• Kimberly Turner
• Tim Turner

• Psychiatric/Mental Health Nurse Practitioner in Fairmont, WV
• Providers in Fairmont, WV by specialty
• Psychiatric/Mental Health Nurse Practitioner in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 18, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.