Kimberly Dawn Tackett, LMT

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

107466 Issued in KY

Practice address

800 Rose St Whitney Hendrickson BLDG RM 306
Lexington, KY 40536-1129

Phone

(859) 323-4325

Fax

(859) 257-0661

NPI assigned

Dec 7, 2018

Last updated

Mar 28, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1544140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1679961600000",
    "number": "1053882753",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 3939",
            "city": "MIDWAY",
            "state": "KY",
            "postal_code": "403473939",
            "telephone_number": "859-221-9532"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 ROSE ST WHITNEY HENDRICKSON BLDG RM 306",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405361129",
            "telephone_number": "859-323-4325",
            "fax_number": "859-257-0661"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "347 Northridge Dr",
            "address_purpose": "LOCATION",
            "city": "Midway",
            "state": "KY",
            "postal_code": "403471129",
            "country_code": "US",
            "telephone_number": "859-221-9532",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "301 N Hamilton St",
            "address_purpose": "LOCATION",
            "city": "Georgetown",
            "state": "KY",
            "postal_code": "403241820",
            "country_code": "US",
            "telephone_number": "502-863-6789",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "KIMBERLY",
        "middle_name": "DAWN",
        "credential": "LMT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-12-07",
        "last_updated": "2023-03-28",
        "certification_date": "2023-03-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "KY",
            "license": "107466",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amy E Tackett, PHARM D
• Chadwick Trei Tackett, MSN, FNP
• Jessica Faith Tackett, PHARMD
• Jim R Tackett, PA-C
• Kayce Ann Tackett, MD
• Madison Bailey Tackett, MD
• Madison Steffi Tackett, DO
• Reva Duff Tackett, MD
• Stephanie R Tackett
• Steven Wesley Tackett

• Massage Therapist in Lexington, KY
• Providers in Lexington, KY by specialty
• Massage Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 28, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.