PHILLIP TUCKER (NPI# 1730553512) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1730553512 |
| Entity Type | Individual |
| Full Name | PHILLIP TUCKER |
| Credential | ATC, LAT |
| Practice Address |
12613 S Western Ave Oklahoma City OK 73170-6903 |
| Mailing Address |
2609 Se 7th St Moore OK 73160-6776 |
| Practice Telephone | 4057354800 |
| Mailing Telephone | 5802140782 |
| Enumeration Date | 2015-11-17 |
| Last Update Date | 2015-11-17 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
695 | OK | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952860397 | Phillip Michael Tucker | Counselor | 3889 Wonderland Ln, Sevierville, TN 37862-8288 | 2019-03-15 |
| 1538282652 | Phillip J Tucker | Case Manager/Care Coordinator | 201 Deermount St, Ketchikan, AK 99901-6649 | 2007-04-06 |
| Street Address |
12613 S WESTERN AVE |
| City | OKLAHOMA CITY |
| State | OK |
| Zip Code | 73170-6903 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1144847542 | Premier Healthcare, Aprn-cnp | Nurse Practitioner | 12208 South Western Avenue, Suite B, Oklahoma City, OK 73170 | 2020-07-01 |
| 1982233565 | Bethany Ann Arthur | Student in an Organized Health Care Education/Training Program | 661 Waterview Rd, Okc, OK 73170 | 2020-04-06 |
| 1952868929 | Ariana N. Ree | Peer Specialist | 328 Sw 147th St, Oklahoma City, OK 73170 | 2019-02-26 |
| 1780151431 | Looking Up Counseling | Counselor | 709 Sw 119th Ste. B1, Okc, OK 73170 | 2018-10-31 |
| 1902385859 | Danell Marie Rahni | Psychologist | 17300 Serrano Dr, Oklahoma City, OK 73170 | 2018-08-11 |
| 1619468378 | Nhan Nguyen | Student in an Organized Health Care Education/Training Program | 10504 S Miller Ave, Oklahoma City, OK 73170 | 2018-05-29 |
| 1740709906 | Hall Podiatry LLC | Clinic/Center | 20 Sw 132nd Terrace, Moore, OK 73170 | 2017-09-19 |
| 1942727896 | Adelaide V South | Dietitian, Registered | 12216 S Land Ave, Oklahoma City, OH 73170 | 2017-08-22 |
| 1477073609 | Mary Ann Hayden | Nurse Practitioner | 3224 Sw 119th Street, Hennessee & Associates, Oklahoma City, OK 73170 | 2017-06-20 |
| 1245762293 | Michael David Detten | Physical Therapist | 10740 S May Ave Ste 111, Oklahoma City, OK 73170 | 2017-03-29 |
| Find all providers in zip 73170 | ||||
| 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 |
|---|---|---|---|---|
| 1679043012 | Maria Isabel Rendon | Specialist/Technologist | 1817 Nw 15th St, Oklahoma City, OK 73106-2023 | 2018-11-28 |
| 1306353685 | Mallery Gray Gannaway | Specialist/Technologist | 12301 N Macarthur Blvd Apt 304, Oklahoma City, OK 73142-3039 | 2018-01-08 |
| 1679092662 | Allison Hadley | Specialist/Technologist | 10900 S Pennsylvania Ave, Oklahoma City, OK 73170-4244 | 2017-09-12 |
| 1609302215 | Yolanda Denise Zamarripa | Specialist/Technologist | 4436 Nw 36th St Apt 6, Oklahoma City, OK 73112-2720 | 2017-05-03 |
| 1972038065 | Rainee Lyne Ball | Specialist/Technologist | 5937 Nw 59th Ct, Oklahoma City, OK 73122-7114 | 2017-04-26 |
| 1326571860 | Damon Glass | Specialist/Technologist | 3110 Sw 89th St Ste C, Oklahoma City, OK 73159-7920 | 2017-04-11 |
| 1205283819 | Jessica Jenkins | Specialist/Technologist | 14400 N Portland Ave, Oklahoma City, OK 73134-4007 | 2016-05-24 |
| 1760849350 | Alisha Grisby | Specialist/Technologist | 11605 Copper Trails Ln, Oklahoma City, OK 73170-4486 | 2016-01-27 |
| 1700243532 | Howard Collin Gentry | Specialist/Technologist | 1231 Nw 79th St, Oklahoma City, OK 73114-1522 | 2016-01-25 |
| 1578938221 | Jeremy Randall | Specialist/Technologist | 1820 Nw 17th St, Oklahoma City, OK 73106-1802 | 2015-12-07 |
| Find all providers in OKLAHOMA CITY | ||||
| City | OKLAHOMA CITY |
| Zip Code | 73170 |
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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.