MR. JACOB WILLIAM TUCKER (NPI# 1366672081) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1366672081 |
| Entity Type | Individual |
| Full Name | MR. JACOB WILLIAM TUCKER |
| Credential | ATC |
| Practice Address |
800 E Locust St Olney IL 62450-2553 |
| Practice Telephone | 6183952131 |
| Practice Fax Number | 6183956289 |
| Mailing Telephone | 6183952131 |
| Mailing Fax Number | 6183956289 |
| Enumeration Date | 2009-07-15 |
| Last Update Date | 2009-07-15 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2255A2300X |
Specialist/Technologist Specialization: Athletic Trainer |
096.002692 | IL | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154774669 | Jacob Tucker | Chiropractor | 7011 Kentwell Ln, Suite 200, Lincoln, NE 68516 | 2016-07-20 |
| 1003130857 | Jacob L. Tucker | Massage Therapist | 903 S Howard St, Walla Walla, WA 99362-3326 | 2010-03-23 |
| Street Address |
800 E LOCUST ST |
| City | OLNEY |
| State | IL |
| Zip Code | 62450-2553 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649252511 | Paul W Sutherland | Surgery | 800 E Locust St, Olney, IL 62450-2553 | 2005-11-16 |
| 1174142665 | Samantha A Lewis | Speech-Language Pathologist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-14 |
| 1972132991 | Clinton David Rauch | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-02 |
| 1629607544 | Ladi Stallard | Physical Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-02 |
| 1770111999 | Kelsey Lynn Runyon | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1801424957 | Katrina Williams | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1700414877 | Whitley Dawn Houchin | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2020-04-01 |
| 1073143475 | Arrow Ambulance, LLC | Ambulance | 800 E Locust St, Olney, IL 62450-2553 | 2020-01-24 |
| 1003452095 | Shay N Farris | Physical Medicine & Rehabilitation | 800 E Locust St, Olney, IL 62450-2553 | 2019-11-25 |
| 1043861883 | Kelsie Ann Harper | Occupational Therapist | 800 E Locust St, Olney, IL 62450-2553 | 2019-09-23 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1851530091 | Donna Harris | Counselor | 515 West St. John Street, Olney, IL 62450 | 2009-02-11 |
| 1942476908 | Christa Dawn Jennette | Private Vehicle | 1113 Keiffer Dr, Olney, IL 62450 | 2008-04-30 |
| 1942491162 | Marion County Horizon Center D/b/a Richland Manor | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 1066 West Main St, Olney, IL 62450 | 2007-08-05 |
| 1811100407 | Advanced Open Mri, Inc. | Clinic/Center | 605 East Main Street, Olney, IL 62450 | 2007-05-08 |
| 1548489958 | Frank Edward Gruber | Dentist | 1108 N East St, Olney, IL 62450 | 2007-04-24 |
| 1508084591 | Melvin Borja Escalona | Physical Therapist | 800 East Locust St., Olney, IL 62450 | 2007-04-23 |
| 1881769826 | Jeffrey Alan Kocher | Chiropractor | 731 S West St, Olney, IL 62450 | 2006-11-22 |
| 1336211523 | Patricia Lynn Kessler Bookhout | Dentist | 1104 North East, Olney, IL 62450 | 2006-11-14 |
| 1639159015 | Bowers Drug Store Inc | Pharmacy | 205 E Main, Olney, IL 62450 | 2006-01-20 |
| 1336137199 | South Eastern Illinois Counseling Center Inc | Counselor | 504 Micah Drive, Drawer M, Olney, IL 62450 | 2005-10-06 |
| Find all providers in zip 62450 | ||||
| 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 |
|---|---|---|---|---|
| 1306471578 | Kari Sue Nohren | Specialist/Technologist | 305 N West St, Olney, IL 62450-1043 | 2020-03-09 |
| 1285026435 | Erin Will | Specialist/Technologist | 17301 Old Vic Blvd, Olney, MD 20832-1603 | 2015-02-25 |
| 1417585399 | Ashley Zajac | Specialist/Technologist | 17301 Old Vic Blvd, Olney, MD 20832-1603 | 2020-03-27 |
| 1770021917 | Kelly Piazza | Specialist/Technologist | 17301 Old Vic Blvd, Olney, MD 20832-1603 | 2017-02-08 |
| 1134570898 | John Vipperman | Specialist/Technologist | 18109 Prince Philip Dr, Olney, MD 20832 | 2016-06-23 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1538771076 | Stacey Weathers-cannon | Specialist/Technologist | 650 Ingraham Ave, Calumet City, IL 60409-4236 | 2020-08-17 |
| 1104438621 | Abril Malagon | Specialist/Technologist | 1 S Greenwood Ave, Palatine, IL 60074-6328 | 2020-08-17 |
| 1265050678 | Megan Elsbree | Specialist/Technologist | 11819 Deacon Dr, Rockton, IL 61072-9411 | 2020-07-13 |
| 1013534437 | Nicole Rose Mondelli | Specialist/Technologist | 958 Tallgrass Dr, Bartlett, IL 60103-5071 | 2020-07-01 |
| 1740806413 | Megan Herter | Specialist/Technologist | 1513 Old Ivy Dr, Springfield, IL 62711-8156 | 2020-06-18 |
| 1164047239 | Madison Stagman | Specialist/Technologist | 280 Douglas Ave Apt 4, Mascoutah, IL 62258-2963 | 2020-06-14 |
| 1588286272 | Sarah Wegrzyn | Specialist/Technologist | 3040 S Wabash Ave, Chicago, IL 60616-3474 | 2020-05-15 |
| 1336761386 | Christine Louise Shebelski | Specialist/Technologist | 15203 Pulaski Rd, Midlothian, IL 60445-3755 | 2020-05-13 |
| 1386266633 | Kathryn Riordan | Specialist/Technologist | 221 Triton Ln, Naperville, IL 60540-7926 | 2020-05-09 |
| 1487276747 | Vianey Hernandez-ramirez | Specialist/Technologist | 4115 Howard St, Skokie, IL 60076-3749 | 2020-05-09 |
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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.