Timothy Paul Tackett Jr., M.D.

Primary specialty

Anesthesiology PhysicianTaxonomy code 207L00000X

License

54724 Issued in TN

Practice address

1265 Union Ave
Memphis, TN 38104-3415

Phone

(901) 725-5846

NPI assigned

May 9, 2012

Last updated

Aug 4, 2016By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN, AR, AL3 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 3

Specialty

Anesthesiology

Education

University of Mississippi School of Medicine, 2012

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Anesthesiologists Associated PCGroup PAC ID 6204739519, 418 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Baptist Health Brookwood Hospital Hospital, Birmingham, AL, CCN 010139

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• Anesthesiologists Associated PC

  • Anesthesiology Physician
  • Birmingham, AL
  • NPI 1851371850
  Medicare reassignment Care Compare group NPD
• Blue Lake Health Alabama, LLC

  • Anesthesiology Physician
  • Florence, AL
  • NPI 1376266726
  Medicare reassignment NPD
• Medical Anesthesia Group, PA

  • Anesthesiology Physician
  • Memphis, TN
  • NPI 1679527501

  AR

  Medicare reassignment
• Anesthesiologists Associated PC

  dba SAM Critical Response Service

  • Critical Care Medicine (Internal Medicine) Physician
  • Birmingham, AL
  • NPI 1396353280
  NPD

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

• BBH BMC, LLC

  dba Baptist Health Brookwood Hospital

  • General Acute Care Hospital
  • Birmingham, AL
  • NPI 1003260480
  Care Compare affiliation

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

{
    "created_epoch": "1336521600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470268800000",
    "number": "1215296462",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6060 PRIMACY PKWY",
            "address_2": "SUITE 241",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381195745",
            "telephone_number": "901-725-5846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1265 UNION AVE",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381043415",
            "telephone_number": "901-725-5846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "TIMOTHY",
        "middle_name": "PAUL",
        "name_suffix": "Jr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-05-09",
        "last_updated": "2016-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TN",
            "license": "54724",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Owen B. Tabor Jr., M.D.
• Owen B. Tabor Sr., M.D.
• Charlie Andrew Tacito
• Deanna Rae Tacker, MS, RD, LDN
• Herman L Tacker, O.D.
• Sarah Taddia
• Zeab Tadesse, PHARMD
• Arnold R Tag, MD
• Miranda Gail Taggart, MD
• Mahboubeh Sayed Taghavi, D.D.S.

• Anesthesiology Physician in Memphis, TN
• Providers in Memphis, TN by specialty
• Anesthesiology Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.