Jereny S Tackett, BA MHA

Primary specialty

Case Manager/Care CoordinatorTaxonomy code 171M00000X

Practice address

7160 N Mayo TRL
Pikeville, KY 41501-3151

Phone

(606) 657-9988

Fax

(606) 653-0691

NPI assigned

Nov 8, 2006

Last updated

May 24, 2023By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts

Interoperability endpoints

• Direct secure messaging: jereny.tackett.p1@direct.mtcomp.nextgenshare.com

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

{
    "created_epoch": "1162944000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684886400000",
    "number": "1184794125",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7160 N MAYO TRL",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013151",
            "telephone_number": "606-657-9988",
            "fax_number": "606-653-0691"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7160 N MAYO TRL",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013151",
            "telephone_number": "606-657-9988",
            "fax_number": "606-653-0691"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JERENY",
        "middle_name": "S",
        "credential": "BA MHA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-11-08",
        "last_updated": "2023-05-24",
        "certification_date": "2023-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": "KY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Casey Austin Tackett
• Christopher Ryan Tackett
• Ellis Ray Tackett III, ATC LAT
• Emily Kalyn Grace Tackett
• Eva Mae Tackett
• Jordan Tackett
• Kayla Danielle Tackett
• Kayla Shane Tackett, PMHNP-BC, APRN
• Kristi Leann Tackett, D.O.
• Laura Tackett, R.N.

• Case Manager/Care Coordinator in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Case Manager/Care Coordinator in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 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.