DR. BRYAN MICHAEL TUCKER (NPI# 1467712943) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1467712943 |
| Entity Type | Individual |
| Full Name | DR. BRYAN MICHAEL TUCKER |
| Credential | D.O., M.S. |
| Practice Address |
Medical Center Boulevard Wake Forest Baptist Health- Nephrology Winston Salem NC 27101 |
| Practice Telephone | 2036884242 |
| Mailing Telephone | (336) 716-4650 |
| Enumeration Date | 2012-05-18 |
| Last Update Date | 2017-08-09 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 207R00000X | Internal Medicine | 390200000 | IN | Allopathic & Osteopathic Physicians |
| Y | 207RN0300X |
Internal Medicine Specialization: Nephrology |
2017-00156 | NC | Allopathic & Osteopathic Physicians |
| N | 390200000X | Student in an Organized Health Care Education/Training Program | Student, Health Care |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790901346 | Bryan Tucker | Marriage & Family Therapist | 1544 B St Ste 2, Hayward, CA 94541-3041 | 2007-04-18 |
| Street Address |
MEDICAL CENTER BOULEVARD WAKE FOREST BAPTIST HEALTH- NEPHROLOGY |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27101 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1679566137 | Arjun Bijoy Chatterjee | Internal Medicine | Medical Center Boulevard, Wfu Som - Pulmonary, Winston Salem, NC 27157-0001 | 2005-08-30 |
| 1821604794 | Luke Mellish | Nurse Anesthetist, Certified Registered | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-09-16 |
| 1588278881 | Kenicia M Walker | Pharmacist | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-09-03 |
| 1841804622 | Kelsey Elizabeth Donovan | Physician Assistant | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-08-31 |
| 1992326714 | Kelsey Elyce Thomas | Physician Assistant | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-05-04 |
| 1376162370 | Elliott Voss | Student in an Organized Health Care Education/Training Program | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-04-10 |
| 1548899784 | Tyler Lynne Overholt | Student in an Organized Health Care Education/Training Program | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-04-08 |
| 1063041176 | Debanjali Upasana Kundu | Student in an Organized Health Care Education/Training Program | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-04-02 |
| 1114555323 | Arthur Zayne Washington IIi | Student in an Organized Health Care Education/Training Program | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-04-01 |
| 1003444100 | Nikita Jain | Student in an Organized Health Care Education/Training Program | Medical Center Boulevard, Winston Salem, NC 27157-0001 | 2020-04-01 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1003421876 | Annie Carolina Mccollum | Occupational Therapist | 3 S Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2020-09-09 |
| 1891321337 | Philippe Ayres | Personal Emergency Response Attendant | 475 Vine St., Bowman Gray Center for Medical Education, Winston-salem, NC 27101 | 2020-03-17 |
| 1497385595 | Aereil Moore | Counselor | 655 West 4th St, Winston Salem, NC 27101 | 2020-01-17 |
| 1619519428 | Brandi Melissa Decriscio | Nurse Practitioner | 1200 N Martin Luther King Jr Drive, Winston-salem, NC 27101 | 2019-10-14 |
| 1316502909 | Burke Street Chiropractic, Pllc | Chiropractor | 1016 Burke St., Winston-salem, NC 27101 | 2019-05-08 |
| 1790349728 | Nakia Carter | Counselor | 1o1o W. Northwest Boulevard, Winston-salem, NC 27101 | 2019-04-25 |
| 1003391251 | Hannah Fortwengler Rainey | Nurse Anesthetist, Certified Registered | Medical Center Blvrd, Winston-salem, NC 27101 | 2018-10-03 |
| 1750875928 | Susan Wilhelm Patterson | Nurse Practitioner | 1200 Martin Luther King Jr Dr, Winston-salem, NC 27101 | 2018-06-20 |
| 1194228049 | Anjanette Gilley Benjamin | Counselor | 650 Highland Ave Ste 1000, Winston Salem, NC 27101 | 2018-03-16 |
| 1376054627 | Paulisha Da-shawna Mcintyre | Social Worker | 650 Highland Ave Ste 101, Winston Salem, NC 27101 | 2017-10-13 |
| Find all providers in zip 27101 | ||||
| Taxonomy Code | 207RN0300X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Internal Medicine |
| Specialization | Nephrology |
| An internist who treats disorders of the kidney, high blood pressure, fluid and mineral balance and dialysis of body wastes when the kidneys do not function. This specialist consults with surgeons about kidney transplantation. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: modified source] - Additional Resources: American Board of Internal Medicine, 2007. http://www.abim.org/. American Osteopathic Board of Internal Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Internal Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Internal Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619157310 | Ravi Kiran Mallavarapu | Internal Medicine | 135 Crowne Chase Dr Apt 5, Winston Salem, NC 27104-3580 | 2007-11-09 |
| 1457452583 | Hugo A Tettamanti Md Pa | Internal Medicine | 2928 Maplewood Ave, Winston Salem, NC 27103-4021 | 2006-09-25 |
| 1275580854 | W. Scott Moore Et Al Ptr | Internal Medicine | 730 Highland Oaks Drive, Suite 201, Winston Salem, NC 27103-7108 | 2006-05-28 |
| 1144279001 | Dialysis Access Group of Wake Forest University, LLC | Internal Medicine | 120 Miller Street, Winston Salem, NC 27103-2500 | 2006-05-09 |
| 1962487397 | Scott Gregory Satko | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2005-12-08 |
| 1376040030 | Riti Rajendra Shah | Internal Medicine | 1 Medical Center Blvd, Winston Salem, NC 27157 | 2018-04-10 |
| 1578944013 | Andrew Henican Spangler | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2015-06-10 |
| 1851787840 | Brooke L Crossley | Internal Medicine | 730 Highland Oaks Dr Ste 201, Winston Salem, NC 27103-7108 | 2015-04-07 |
| 1588077408 | Natalia Sakhovskaya | Internal Medicine | Medical Center Blvd, Winston Salem, NC 27157 | 2014-06-09 |
| 1447676614 | Murtaza Ali Naqvi | Internal Medicine | Medical Center Blvd, Winston Salem, NC 27157-4044 | 2014-03-12 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27101 |
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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.