BRENT AUSTIN TUCKER (NPI# 1396297248) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396297248 |
| Entity Type | Individual |
| Full Name | BRENT AUSTIN TUCKER |
| Credential | PA-C |
| Practice Address |
3414 Olandwood Ct Olney MD 20832-1384 |
| Practice Telephone | 3017740500 |
| Practice Fax Number | 3017747338 |
| Mailing Telephone | 3017740500 |
| Mailing Fax Number | 3017747338 |
| Enumeration Date | 2016-10-26 |
| Last Update Date | 2019-10-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 363A00000X | Physician Assistant | C06263 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| N | 363AM0700X |
Physician Assistant Specialization: Medical |
C06263 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Y | 363AS0400X |
Physician Assistant Specialization: Surgical Technologist |
C06263 | MD | Physician Assistants & Advanced Practice Nursing Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 10710 Charter Dr Ste 300, Columbia, MD 210443260 | 4106441880 | 4107301617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1104858042 | Brent Thomas Tucker | Psychologist | 525.5 Church St, Headland, AL 36345 | 2006-07-07 |
| 1205241668 | Brent Arlenton Tucker | Dentist | 13412 Inglewood Ave, Hawthorne, CA 90250-5603 | 2014-06-24 |
| Street Address |
3414 OLANDWOOD CT |
| City | OLNEY |
| State | MD |
| Zip Code | 20832-1384 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1043212277 | Charles Francis Mess Sr. | Orthopaedic Surgery | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2005-06-01 |
| 1568061281 | Samantha Nicole Gasior | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2020-10-23 |
| 1942817697 | Cindy Lorena Uruburo Luengas | Physical Therapist | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2020-09-28 |
| 1891150710 | Hannah Just | Physical Therapist | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2015-12-18 |
| 1700140654 | Jessica M Figueroa | Orthopaedic Surgery | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2012-06-26 |
| 1386920007 | Neeraj Harry | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2011-10-26 |
| 1467734301 | Eilnaz Momenzadeh | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832 | 2011-09-16 |
| 1235384637 | William Robert Volk | Orthopaedic Surgery | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2008-11-26 |
| 1619146396 | The Training Room Inc | Durable Medical Equipment & Medical Supplies | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2008-02-26 |
| 1649495409 | Christina M Goodnough | Physical Therapist | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2007-04-16 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417443532 | Ludmila Costenco | Behavior Technician | 18218 Fox Chase Cir, Olney, MD 20832 | 2018-07-02 |
| 1912422874 | Shannon Denham Nguy | Nurse Practitioner | 18109 Prince Philip Dr Ste 300, Olney, MD 20832 | 2017-08-11 |
| 1578092904 | Rodney John Bohlmann | Naturopath | 17517 Queen Elizabeth Drive, Olney, MD 20832 | 2017-06-08 |
| 1972999746 | Arooj Babar | Internal Medicine | 18101 Prince Philip Dr Ste 230n, Olney, MD 20832 | 2015-04-08 |
| 1437547684 | Cynthia Ann Cook | Social Worker | 18006 Vintage River Terrace, Olney, MD 20832 | 2014-12-22 |
| 1598165334 | Gedion Haile | Pharmacist | 3110 Onley Sandy Spring Rd, Onley, MD 20832 | 2014-08-29 |
| 1285047902 | Melanie Ann Grady | Family Medicine | 18109 Prince Phillip Drive, Suite B200, Olney, MD 20832 | 2014-06-10 |
| 1063847267 | Mari Nako Tchantcho | Home Health Aide | 17149 Moss Side Lane, Olney, MD 20832 | 2013-09-06 |
| 1033558358 | Emily Sue Browning | Dentist | 3416 Olandwood Court, Suite 205, Suite 205, Olney, MD 20832 | 2013-06-19 |
| 1487093167 | Centers for Advanced Orthopaedics, LLC | Orthopaedic Surgery | 3414 Olandwood Court, Olney, MD 20832 | 2013-06-17 |
| Find all providers in zip 20832 | ||||
| Taxonomy Code | 363AS0400X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Surgical Technologist |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659743623 | Linda Lee | Physician Assistant | 18109 Prince Philip Dr Ste 325, Olney, MD 20832-1576 | 2015-10-29 |
| 1023461951 | Shawn Chong | Physician Assistant | 18109 Prince Philip Dr, Suite 300, Olney, MD 20832-1519 | 2016-07-15 |
| 1386038198 | Natalie Karkhanis | Physician Assistant | 18101 Prince Philip Dr, Olney, MD 20832-1514 | 2015-03-19 |
| 1770912107 | Alison Tourville | Physician Assistant | 18101 Prince Philip Dr, Olney, MD 20832-1514 | 2013-11-06 |
| 1801158787 | Olney Hamilton Hospital District | Physician Assistant | 901 W Hamilton St, Olney, TX 76374-1725 | 2012-06-15 |
| 1467734301 | Eilnaz Momenzadeh | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832 | 2011-09-16 |
| 1134242399 | Maria Elena Marcos Espina | Physician Assistant | 18109 Prince Philip Dr, Suite 300, Olney, MD 20832-1519 | 2007-04-10 |
| 1962525642 | Allison Chappelear Moffett | Physician Assistant | 18101 Prince Philip Dr, Olney, MD 20832-1514 | 2007-04-09 |
| 1336157080 | Richard Edward Bizjak | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2006-08-04 |
| 1104834878 | Ronald L Swaim | Physician Assistant | 3414 Olandwood Ct, Olney, MD 20832-1384 | 2006-08-04 |
| Find all providers in OLNEY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.