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Deactivated NPI 1194709659 Deactivated / Inactive NPI Male Practitioner

David R Tucker , PA

Physician Assistant • Iron Mountain, MI

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Notice of NPI Deactivation & Inactive Practice Status

According to official public domain records published by CMS (Centers for Medicare & Medicaid Services) in the National Provider Identifier (NPPES) Registry, David Tucker has officially deactivated this NPI record and ceased active healthcare practice.

Registration / Start Date November 30, 2005
NPI Deactivation Date April 17, 2025
Total Practice Duration ~20 Years of Practice (2005 – 2025)

Professional Overview & Biography Verified Profile Summary

David Tucker, PA was a registered Physician Assistant practicing in Iron Mountain, MI. Throughout an active medical career spanning 20 years, David Tucker provided care at the practice location at 1721 S STEPHENSON AVE until profile deactivation on 2025-04-17.

Practice Location & Contact Primary Location

Practice Address

1721 S Stephenson Ave

Iron Mountain, MI 498013637

Telephone 9067741313
Fax 9067765639
Associated Practice Facility / Clinic

Specialty Benchmarks & Practice Insights

Comparative analytics for Physician Assistant in Iron Mountain, MI

Active Practitioner
Practitioner Clinical Experience
Active
City Avg: 15.5 Yrs
State Avg: 12.2 Yrs
Regional Practice Density
19 Specialists

Practicing in Iron Mountain, MI (7057 Statewide)

Telehealth Adoption Rate
0.0% Regional Adoption

In-Person Office Visits Only

Medicare Pricing Discount
67.4% Avg Savings

Under CMS Medicare Fee Schedule vs Standard Submitted Charges

Medical Specialties & State Licenses

Physician Assistant Primary Specialty

NUCC Taxonomy Code: 363A00000X

State License MI 5601002228

A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.

Practice Associates & Co-Workers

Healthcare professionals and specialists practicing at this location or sharing practice phone/fax

35 Associated Practitioners
Jennifer Morrow , CRNA

Nurse Anesthetist, Certified Registered

NPI 1003388216

Certified Registered Nurse Anesthetist

Brandon Rogers , FNP-BC

Nurse Practitioner

NPI 1053195297

Family Nurse Practitioner (Board Certified)

Laura Vivio-Karle , PA-C

Physician Assistant

NPI 1063700854

Physician Assistant (Certified)

Dr. David Timm , MD

Radiology - Diagnostic Radiology

NPI 1114121746

Doctor of Medicine (M.D.)

Dr. Dale Shampo , MD

Radiology - Diagnostic Radiology

NPI 1124107917

Doctor of Medicine (M.D.)

Lauren Hicks , OTR, L

Occupational Therapist

NPI 1154202034

Occupational Therapist Registered, L

Career & Practice History Timeline

Chronological log of verified NPI updates, location relocations, credentials, and registry changes

7 Historical Events
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NPI Profile Deactivated April 17, 2025

Record deactivated on April 17, 2025

NPI Profile Active July 09, 2007

NPI status registered as active in NPPES database

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Updated Practice Location July 09, 2007

Registered at 1721 S STEPHENSON AVE, IRON MOUNTAIN, MI 498013637 (Tel: 9067741313)

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Updated Business Mailing Address July 09, 2007

Registered at 1721 S STEPHENSON AVE, PO BOX 549, IRON MOUNTAIN, MI 498013637 (Tel: 9067741313)

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Provider Name / Credentials Updated July 09, 2007

Recorded as DAVID TUCKER, PA

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Medical Taxonomy / Specialty Registered (Primary Specialty) July 09, 2007

Physician Assistant (License #5601002228 in MI)

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Initial NPI Registration & Enumeration November 30, 2005

First registered as active Individual Practitioner in NPPES Database.

Patient & Community Reviews

Verified patient ratings, medical care experiences, and facility photos

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NPI Administrative Meta

NPI Number: 1194709659
Entity Type:
Individual Provider Physician, Nurse Practitioner, or Solo Healthcare Professional (Type 1 NPI)
Enumeration Date: November 30, 2005
Last Update: July 09, 2007
Deactivation Date: April 17, 2025

Mailing Address

1721 S Stephenson Ave, Po Box 549

Iron Mountain, MI 498013637

Phone: 9067741313

Public Domain Record This profile contains public domain information published by CMS and NPPES under the Freedom of Information Act (FOIA).
⚠️ Medical Disclaimer

This directory listing is for informational purposes only and does not constitute medical advice, diagnosis, or physician endorsement. If you are experiencing a medical emergency, please call 911 immediately.