TAYLOR ROSS TUCKER
NPI 1215677844
Student in an Organized Health Care Education/Training Program in Little Rock, AR

Active since March 31, 2022PECOS Enrolled
4301 W MARKHAM ST # 500, LITTLE ROCK, AR 72205(501) 296-1165 Get Directions Write a Review

NPPES record last updated: March 31, 2022. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Taylor Ross Tucker NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

TAYLOR ROSS TUCKER (NPI 1215677844) is an individual student in an organized health care education/training program in Little Rock, Arkansas and active in the NPI registry since March 2022. He is enrolled in Medicare PECOS and maintains a secondary practice location in Little Rock.

NPPES Registry Identity

NPI1215677844
Entity TypeIndividualMale
Primary Taxonomy390200000X
Provider Legal NameTAYLOR ROSS TUCKER
Location Address4301 W MARKHAM ST # 500Little Rock, AR 72205-7101
Mailing Address4301 W Markham St # 500Little Rock, AR 72205-7101
Sole ProprietorYes
Enumeration DateMarch 31, 2022
NPPES CertifiedMarch 31, 2022
NPI 1215677844 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

Taxonomy Code390200000X
Definition

An individual who is enrolled in an organized health care education/training program leading to a degree, certification, registration, and/or licensure to provide health care.

4301 W MARKHAM ST # 500, Little Rock, AR 72205

Secondary Practice Location 1

Location 11 Childrens Way # 500Little Rock, AR 72202-3500 · Phone (501) 296-1165

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

Enrolled in Medicare (PECOS)

Taylor Ross Tucker is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer Part B Labs & Imaging Durable Medical Equipment Home Health Agency Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Nurse Practitioner (Family)
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Nurse Practitioner (Acute Care)
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Nurse Practitioner (Family)
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Physician Assistant
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Student in an Organized Health Care Education/Training Program
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205
Nurse Practitioner (Acute Care)
4301 W MARKHAM ST # 500
LITTLE ROCK, AR 72205

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1215677844, enumerated as an "individual" on March 31, 2022.

The provider is located at 4301 W MARKHAM ST # 500 LITTLE ROCK, AR 72205 and the phone number is (501) 296-1165.

Student in an Organized Health Care Education/Training Program with taxonomy code 390200000X.