NPIMap

Individual provider Active NPI

Tannika Christensen, M.D.

  • Family Medicine Physician
  • La Grange, KY
National Provider Identifier
1053481820
Registry record updated Dec 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
41864 Issued in KY
Practice address
1023 New Moody LN
Suite 201
La Grange, KY 40031-9177
Phone
(502) 225-4480
Fax
(502) 225-9169
NPI assigned
Nov 9, 2006
Last updated
Dec 2, 2020By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 2, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 41864 KY Primary

Addresses

Primary practice location

1023 New Moody LN
Suite 201
La Grange, KY 40031-9177

Mailing address

1023 New Moody LN
Suite 201
La Grange, KY 40031-9177
Phone (502) 225-4480

Other identifiers 5

IdentifierTypeStateIssuer
3754512000OtherKYPASSPORT ADVANTAGE
7100093970MedicaidKY
50026877OtherKYPASSPORT HEALTH PLAN
D5341MedicaidUT
P00757041OtherKYMEDICARE RR

Other names 1

  • Tannika Christensen Former name

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address tchristensen6327@bhkydirect.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20091019000526 KY Practitioner - Family Practice 3678473790 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Utah School of Medicine, 2001
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1031 New Moody Lane
Suite 201
Lagrange, KY 40031-9151
Phone (502) 721-6008

1031 New Moody LN
La Grange, KY 40031-9151

3900 Kresge Way
Louisville, KY 40207-4681

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
41864KYMDFamily Medicine Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2015 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Oct 1, 2015 Accepting new patients
Baptist Healthcare System, Inc. Past Accepting new patients

Locations

1023 New Moody Ln
Ste 201
Lagrange, KY 40031
Phone (502) 225-4480

3900 Kresge Way
Ste 41
Louisville, KY 40207
Phone (502) 896-1313

5200 Commerce Crossings Dr
Fl 3
Louisville, KY 40229
Phone (502) 253-4924

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 17

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

View all 17

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1163030400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1606867200000",
    "number": "1053481820",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1023 NEW MOODY LN",
            "address_2": "SUITE 201",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319177",
            "telephone_number": "502-225-4480",
            "fax_number": "502-225-9169"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1023 NEW MOODY LN",
            "address_2": "SUITE 201",
            "city": "LA GRANGE",
            "state": "KY",
            "postal_code": "400319177",
            "telephone_number": "502-225-4480",
            "fax_number": "502-225-9169"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CHRISTENSEN",
        "first_name": "TANNIKA",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-11-09",
        "last_updated": "2020-12-02",
        "certification_date": "2020-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "41864",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT ADVANTAGE",
            "identifier": "3754512000",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100093970",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT HEALTH PLAN",
            "identifier": "50026877",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "D5341",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICARE RR",
            "identifier": "P00757041",
            "state": "KY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "tchristensen6327@bhkydirect.com",
            "affiliation": "N",
            "address_1": "1023 New Moody Ln",
            "address_2": "Suite 201",
            "city": "LA Grange",
            "state": "KY",
            "country_code": "US",
            "postal_code": "400319177",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": [
        {
            "first_name": "TANNIKA",
            "last_name": "CHRISTENSEN",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in La Grange, KY

Sources for this page

Verify at the official NPI Registry.