Walter Robert Tucker, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

19417 Issued in NC

Practice address

8420 University Exec Park Dr Ste 850
Charlotte, NC 28262-1308

Phone

(704) 384-1225

Fax

(704) 384-1226

NPI assigned

Jun 23, 2006

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

Other identifiers 1

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: wtucker20599@direct.novanthealth.org

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

{
    "created_epoch": "1151020800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1992731996",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 60447",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282600447",
            "telephone_number": "704-384-1225",
            "fax_number": "704-384-1226"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8420 UNIVERSITY EXEC PARK DR STE 850",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282621308",
            "telephone_number": "704-384-1225",
            "fax_number": "704-384-1226"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "125 Queens Rd Ste 330",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282043419",
            "country_code": "US",
            "telephone_number": "704-384-5043",
            "fax_number": "704-384-8895",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "8310 University Exec Park Dr",
            "address_2": "Suite 550",
            "address_purpose": "LOCATION",
            "city": "Charlotte",
            "state": "NC",
            "postal_code": "282623383",
            "country_code": "US",
            "telephone_number": "704-384-1225",
            "fax_number": "704-384-1226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TUCKER",
        "first_name": "WALTER",
        "middle_name": "ROBERT",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-23",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NC",
            "license": "19417",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8983931",
            "state": "NC"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "WTUCKER20599@DIRECT.NOVANTHEALTH.ORG",
            "affiliation": "N",
            "address_1": "8310 University Exec Park Dr",
            "address_2": "Suite 550",
            "city": "Charlotte",
            "state": "NC",
            "country_code": "US",
            "postal_code": "282623383",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Margaret Mary Tucker, LCSWA
• Myron R Tucker, DDS
• Peter Loren Tucker, MD
• Rina G Tucker, LCMHCA
• Shannon Lynn Tucker, M.A., CCC-SLP
• William Stuart Tucker Jr., MD
• Alexandra Tulloch, LCMHC
• Danielle Y Tulloch, RN
• Sarah Flora Tuluenga
• Yanki Tumer, M.D.

• All providers in Charlotte, NC
• Family Medicine Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.