Physician Compare National (NPI:1972159028)

HEALTHCARE PROVIDER: SHANTE VENISHA TUCKER FNP

Physician Compare National contains general information about individual eligible professionals (EPs) such as demographic information and Medicare quality program participation.

Individual Professional Information
NPI	1972159028
	Unique healthcare provider (clinician) ID assigned by NPPES
PECOS UID	8729310818
	Unique individual clinician ID assigned by PECOS
Professional Enrollment ID	I20191022002017
	Unique ID for the individual professional enrollment that is the source for the data in the observation
Provider Last Name	TUCKER
	Individual professional last name
Provider First Name	SHANTE
	Individual professional first name
Provider Gender	F
	The provider's gender if the provider is a person.

Medical School Information
Medical School Name	OTHER
	Individual professional's medical school
Graduation Year	2019
	Individual professional's medical school graduation year
Primary Specialty	NURSE PRACTITIONER
	Primary medical specialty reported by the individual professional in the selected enrollment

Practice Information
Organization Legal Name	INSIGHT PHYSICIANS PC
	Legal name of the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Group Practice PAC ID	2860394178
	Unique Group Practice ID assigned by PECOS to the Group Practice that the individual professional works with- will be blank if the address is not linked to a Group Practice
Number of Group Practice members	16
	Total number of individual professionals affiliated with the Group Practice based on Group Practice PAC ID
Line 1 Street Address	2006 BREMO RD
	Group Practice or individual's line 1 address
Line 2 Street Address	SUITE 101
	Group Practice or individual's line 2 address
City	RICHMOND
	Group Practice or individual's city
State	VA
	Group Practice or individual's state
Zip Code	232262438
	Group Practice or individual's zip code (9 digits when available)
Phone Number	8042881881
	Phone number is listed only when there is a single phone number available for the practice location address

Hospital(s) Affiliation Information
Hospital Affiliation CCN 1	490094
	Medicare CCN of hospital where individual professional provides service 1
Hospital Affiliation LBN 1	BON SECOURS RICHMOND COMMUNITY HOSPITAL
	Legal business name of hospital where individual professional provides service 1
Hospital Affiliation CCN 2	490118
	Medicare CCN of hospital where individual professional provides service 2
Hospital Affiliation LBN 2	HENRICO DOCTORS' HOSPITAL
	Legal business name of hospital where individual professional provides service 2
Hospital Affiliation CCN 3	490069
	Medicare CCN of hospital where individual professional provides service 3
Hospital Affiliation LBN 3	BON SECOURS MEMORIAL REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 3
Hospital Affiliation CCN 4	490141
	Medicare CCN of hospital where individual professional provides service 4
Hospital Affiliation LBN 4	SPOTSYLVANIA REGIONAL MEDICAL CENTER
	Legal business name of hospital where individual professional provides service 4
Professional Accepts Medicare Assignment	Y