VICTOR JASON TUCKER (NPI# 1104800390) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104800390 |
| Entity Type | Individual |
| Full Name | VICTOR JASON TUCKER |
| Credential | PA-C |
| Practice Address |
20 Riverbend Dr Sw Rome GA 30161-6066 |
| Practice Telephone | 7062950070 |
| Practice Fax Number | 7062351618 |
| Mailing Telephone | 7062950070 |
| Mailing Fax Number | 7062351618 |
| Enumeration Date | 2005-12-01 |
| Last Update Date | 2007-07-08 |
| Gender Code | M |
| Is Sole Proprietor | X |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 363AM0700X |
Physician Assistant Specialization: Medical |
3922 | GA | Physician Assistants & Advanced Practice Nursing Providers |
| Street Address |
20 RIVERBEND DR SW |
| City | ROME |
| State | GA |
| Zip Code | 30161-6066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1952385254 | Louis A Dinatti | Emergency Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2005-12-01 |
| 1639309065 | Brown Family Medicine, LLC | Family Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2009-07-20 |
| 1174784912 | Rome Neurospinal Center PC | Neurological Surgery | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2008-06-24 |
| 1316115538 | Coosa Neurology PC | Psychiatry & Neurology | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2008-02-11 |
| 1124200100 | Coosa Neurosurgery PC | Neurological Surgery | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2007-11-30 |
| 1932311123 | North Georgia Nephrology Associates PC | Internal Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2007-05-03 |
| 1104905074 | Hamid Reza Chimeh | Internal Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2006-11-03 |
| 1588698054 | Kevin E Brown | Family Medicine | 20 Riverbend Dr Sw, Rome, GA 30161-6066 | 2006-07-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1265069256 | Three Rivers Housing and Development Corporation | Chore Provider | 326 W. 9th St, Rome, GA 30161 | 2020-03-27 |
| 1144865957 | Eric Alan Fuller | Audiologist-Hearing Aid Fitter | 700 East 2nd Street, Suite C, Rome, GA 30161 | 2019-11-15 |
| 1003394883 | Cindy V Shelton | Health Educator | 204 E 1st Ave, Rome, GA 30161 | 2018-08-02 |
| 1083153597 | Julie Oglesby Allen | Counselor | 1 S Broad St Sw Ste 5, Rome, GA 30161 | 2017-02-16 |
| 1902299530 | Michael Thomas Phillips | Pharmacist | 2005 Maple Street, Rome, GA 30161 | 2015-03-06 |
| 1407259112 | Angela Smith | Community/Behavioral Health | 109 John Maddox Suite 200, Rome, GA 30161 | 2014-10-08 |
| 1215344379 | Nancy Patel | Pharmacist | 1421 North Broad St, Rome, GA 30161 | 2014-07-21 |
| 1821336629 | Wendy Pence | Nurse Practitioner | 3001 Turner Mccall Blvd, Rome, GA 30161 | 2013-01-29 |
| 1558526202 | Marilyn Teresa Ringstaff | Registered Nurse | 1513 Dean St., Rome, GA 30161 | 2008-07-22 |
| 1134310147 | Reneka L Dobbs-jackson | Family Medicine | 420 E 2nd Ave Ste 103, Rome, GA 30161 | 2007-08-05 |
| Find all providers in zip 30161 | ||||
| Taxonomy Code | 363AM0700X |
| Grouping | Physician Assistants & Advanced Practice Nursing Providers |
| Classification | Physician Assistant |
| Specialization | Medical |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801402888 | Meredith Gaines | Physician Assistant | 603 W 1st St Unit 1, Rome, GA 30161-3067 | 2020-09-16 |
| 1639153810 | Leone P Cordle | Physician Assistant | 126 Three Rivers Dr Ne, Rome, GA 30161-4999 | 2005-12-01 |
| 1124636527 | Alan Phrommala | Physician Assistant | 501 Redmond Rd Nw, Rome, GA 30165-1415 | 2020-07-21 |
| 1417371642 | William Brandon Newby | Physician Assistant | 18 Riverbend Dr Sw, Suite 120, Rome, GA 30161-6013 | 2014-02-07 |
| 1639437379 | Staci Robin Graves | Physician Assistant | 715 E 2nd Ave Sw, Rome, GA 30161-6148 | 2012-05-01 |
| 1669559795 | Christina Lyndell Miller | Physician Assistant | 1500 N James St, Rome, NY 13440-2844 | 2006-11-01 |
| 1902999865 | Jeffery Scott Roy | Physician Assistant | 91 Perimeter Rd, Suite 100, Rome, NY 13441-4018 | 2006-10-02 |
| 1336258268 | Gregory Lee Fisher | Physician Assistant | 420 E 2nd Ave, Suite 103, Rome, GA 30161-3209 | 2006-08-30 |
| 1609884196 | Jennifer M Goldbach | Physician Assistant | 304 Turner Mccall Blvd Sw, Rome, GA 30165-5621 | 2006-08-03 |
| 1093723454 | Henry G. Wood | Physician Assistant | 310 W 10th St Ne, Rome, GA 30165-2639 | 2006-08-03 |
| Find all providers in ROME | ||||
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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.