MR. JONATHAN TUCKER (NPI# 1417470337) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1417470337 |
| Entity Type | Individual |
| Full Name | MR. JONATHAN TUCKER |
| Credential | LAT |
| Practice Address |
1801 S Stewart St Azle TX 76020-3068 |
| Mailing Address |
7083 Briar Rd Azle TX 76020-7033 |
| Practice Telephone | 8172535820 |
| Mailing Telephone | 8172535820 |
| Enumeration Date | 2017-07-23 |
| Last Update Date | 2018-03-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
AT5626 | TX | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 7083 Briar Road, Azle, TX 76020 | (817) 253-5820 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1831252840 | Jonathan Daniel Tucker | Dentist | 10703 E. Crystal Falls Pkwy, Leander, TX 78641-2259 | 2006-12-19 |
| 1679139505 | Jonathan M Tucker | Case Manager/Care Coordinator | 1490 E Main St, Columbus, OH 43205-2140 | 2019-05-16 |
| 1912126699 | Jonathan Tucker | Social Worker | 6555 W Maple Rd, West Bloomfield, MI 48322-4926 | 2007-04-24 |
| 1992824932 | Jonathan Tucker | Counselor | 1200 S Broad St, Winston Salem, NC 27101-5760 | 2007-03-29 |
| Street Address |
1801 S STEWART ST |
| City | AZLE |
| State | TX |
| Zip Code | 76020-3068 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1306447537 | Azle Cube Smiles Pllc | Dentist | 100 Park Plc Ste 224, Azle, TX 76020 | 2020-11-04 |
| 1992112650 | Euverse Neuromonitoring LLC | Neurological Surgery | 1244 Boling Ranch Road N, Azle, TX 76020 | 2014-07-15 |
| 1124378351 | Kathleen C. Anderson | Speech-Language Pathologist | 15873 Flying Jib Dr., Azle, TX 76020 | 2012-09-14 |
| 1386886703 | Janie Darlene Holder | Specialist/Technologist, Other | 10934 Power Squadron Rd., Azle, TX 76020 | 2009-03-31 |
| 1245442367 | Joseph S Mccreary | Dentist | 209 Roe St, Azle, TX 76020 | 2007-05-03 |
| 1659491207 | Phyllis Ann Nelson | Dietitian, Registered | 108 Denver Trail, Harris Methodist Northwest Hospital, Azle, TX 76020 | 2007-03-29 |
| 1548386824 | Terry L Moore | Dentist | 500 Boyd Court, Colleyville, TX 76020 | 2007-03-21 |
| 1437177862 | James Lee Masson | Chiropractor | 1025 Southeast Parkway, Azle, TX 76020 | 2006-07-17 |
| 1982609269 | Azle Manor Health Care, L.l.l.p. | Skilled Nursing Facility | 721 Dunaway Ln, Azle, TX 76020 | 2005-06-14 |
| 1154801165 | Shayna Colleen Lacy | Occupational Therapist | 721 Dunaway Ln, Azle, TX 76020 | 2018-08-19 |
| Find all providers in zip 76020 | ||||
| Taxonomy Code | 2255A2300X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Specialist/Technologist |
| Specialization | Athletic Trainer |
| Athletic trainers are allied health care professionals who work in consultation with or under the direction of physicians, and specialize in the prevention, assessment, treatment and rehabilitation of injuries and illnesses. Currently, the entry-level employment requirements are a bachelor’s degree with a major in athletic training from an accredited university or college. A majority of athletic trainers hold advanced degrees. National board certification is generally required as a condition of state licensure and employment. Most states regulate athletic trainers, and they practice within the scope of that license or regulation. Clinical practice includes emergency care, rehabilitation, reconditioning, therapeutic exercise, wellness programs, exercise physiology, kinesiology, biomechanics, nutrition, psychology and health care administration. |
| Notes: Source: National Athletic Trainers’ Association (www.NATA.org) [1/1/2006: modified definition, modified source] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821593930 | Christopher Dillon Bagwell | Specialist/Technologist | 829 Nation Dr, Azle, TX 76020-3521 | 2018-03-29 |
| 1689027039 | Tiffany Shaw | Specialist/Technologist | 1200 Boyd Rd, Azle, TX 76020-2522 | 2016-07-21 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1255932562 | Kyndall Leigh Soukup | Specialist/Technologist | 16002 Rosethorn Ct, Cypress, TX 77429-3490 | 2020-11-03 |
| 1447850631 | Claire Oliver-dehaven | Specialist/Technologist | 7012 Ridgetop Rd, North Richland Hills, TX 76182-3331 | 2020-10-28 |
| 1609476894 | Tessa Mcelroy | Specialist/Technologist | 1606 Trail Glen Ct, Pantego, TX 76013-3152 | 2020-10-28 |
| 1265031702 | Kiana Angelique Leveston | Specialist/Technologist | 2820 W Frey St Apt 7209, Stephenville, TX 76401-1905 | 2020-10-24 |
| 1205435856 | Jessica Moreno | Specialist/Technologist | 3718 Duck Creek Dr, Garland, TX 75043-2962 | 2020-10-23 |
| 1437758612 | Dina Y Scott | Specialist/Technologist | 107 N Greenville Ave Ste B, Allen, TX 75002-9161 | 2020-10-20 |
| 1275131864 | Kasie Bell | Specialist/Technologist | 215 Richland Dr, Kilgore, TX 75662-2049 | 2020-10-15 |
| 1184222663 | Zachary Mitchell Kimo Mitsui | Specialist/Technologist | 7311 Bluestone Rd, San Antonio, TX 78249 | 2020-10-15 |
| 1538766191 | Francisco Ruben Perez | Specialist/Technologist | 2503 6th St, Lubbock, TX 79409-9806 | 2020-10-07 |
| 1356958128 | Brandi Neeley | Specialist/Technologist | 12131 Kirby Dr, Houston, TX 77045-4857 | 2020-09-25 |
| Find all providers with the same taxonomy | ||||
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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.