Individual provider Active NPI

Brittany Tackett

  • Family Nurse Practitioner
  • Louisa, KY
National Provider Identifier
1174173538
Registry record updated Apr 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3013582 Issued in KY
Practice address
125 S Main Cross St
Louisa, KY 41230-1065
Phone
(606) 638-0938
NPI assigned
Sep 18, 2019
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3013582 KY Primary

Addresses

Primary practice location

125 S Main Cross St
Louisa, KY 41230-1065

Mailing address

PO Box 726
Louisa, KY 41230-0726

Other practice location 1

255 Church St Ste 101
Pikeville, KY 41501-3476
Phone (606) 260-8613

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20200807001480 KY Practitioner - Nurse Practitioner 8224453295 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Commonwealth Pain Associates PLLCGroup PAC ID 0941441919, 156 clinicians

Practice addresses (Care Compare)

255 Church St
Suite 101
Pikeville, KY 41501-3476
Phone (606) 260-8613

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.99 of 100Reported as group
Quality
81.97
Promoting interoperability
97
Improvement activities
40
Cost
77.29

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
3013582KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Brock Medical, LLC CurrentSince Jul 27, 2020 Accepting new patients
Fast Pace Kentucky PLLC CurrentSince Jul 27, 2020 Accepting new patients
Commonwealth Pain Associates PLLC CurrentSince Apr 18, 2024 Accepting new patients
Commonwealth Pain Associates, PLLC Family CurrentSince Apr 18, 2024 Accepting new patients
Chess Medicine PLLC Past Accepting new patients

Locations

110 W John Rowan Blvd
Bardstown, KY 40004
Phone (502) 337-7409

15100 N US Highway 25 E
Ste 1
Corbin, KY 40701
Phone (606) 261-2054

101 Prosperous Pl
Ste 300
Lexington, KY 40509
Phone (859) 271-3114

100 London Mountain View Dr
Fl 1
London, KY 40741
Phone (859) 275-5229

1649 Highway 192 W
London, KY 40741
Phone (606) 330-0055

255 Church St
Ste 101
Pikeville, KY 41501
Phone (606) 260-8613

120 Executive Park
St Matthews, KY 40207
Phone (502) 409-9925

Interoperability endpoints

  • Direct secure messaging: brittany.tackett.1@16521.direct.athenahealth.com

Organizations & group practices 5

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

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1568764800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713830400000",
    "number": "1174173538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 726",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412300726"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S MAIN CROSS ST",
            "city": "LOUISA",
            "state": "KY",
            "postal_code": "412301065",
            "telephone_number": "606-638-0938"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "255 Church St Ste 101",
            "address_purpose": "LOCATION",
            "city": "Pikeville",
            "state": "KY",
            "postal_code": "415013476",
            "country_code": "US",
            "telephone_number": "606-260-8613",
            "fax_number": "859-977-2683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "BRITTANY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-09-18",
        "last_updated": "2024-04-23",
        "certification_date": "2024-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013582",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Louisa, KY

Sources for this page

Verify at the official NPI Registry.