Active NPI
Tammie L Emerson-Johnson, FNP
- Nurse Practitioner
- Whitley City, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Nurse Practitioner
- License
- 3202P
- Practice address
- 71 Medical LN
Whitley City, KY 42653-4216 - Phone
- (606) 376-7212
- NPI assigned
- Nov 23, 2005
- Last updated
- Jan 15, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Nurse Practitioner | 363L00000X | 3202P | KY | Primary |
Addresses
Primary practice location
71 Medical LN
Whitley City, KY 42653-4216
Mailing address
PO Box 54
728 Wilburn Ross Hwy
Stearns, KY 42647-0054
Phone (606) 376-9544
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 78004090 | Medicaid | KY |
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
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 1999
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
57 Hogue Rd
Pine Knot, KY 42635-7003
Phone (606) 376-7212
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 3202P | KY | MD | Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Southfork Medical Clinic PLLC | Current | Accepting new patients | |
| Southfork Medical Clinic PLLC | Current | Accepting new patients | |
| Cumberland Family Clinic, PLLC | Current | Accepting new patients |
Locations
57 Hogue Rd
Pine Knot, KY 42635
Phone (606) 354-9444
71 Medical Ln
Whitley City, KY 42653
Phone (606) 376-7212
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Cumberland Family Clinic, PLLC | Rural health clinic | 5% Or Greater Direct Ownership Interest (50%) | Mar 1, 2012 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Pine Knot, KY
- NPI 1366703159
5% Or Greater Direct Ownership Interest
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.
-
- Rural Health Clinic/Center
- Pine Knot, KY
- NPI 1366703159
-
dba South Fork Clinic PLLC
- Rural Health Clinic/Center
- Whitley City, KY
- NPI 1205616265
-
- Specialist
- Whitley City, KY
- NPI 1295718757
Hospital & facility affiliations 3
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Baptist Health Corbin
- General Acute Care Hospital
- Corbin, KY
- NPI 1902865389
-
dba Lake Cumberland Regional Hospital
- Rural Acute Care Hospital
- Somerset, KY
- NPI 1619038247
-
dba Lifeline Health Care of Pulaski
- Home Health Agency
- Somerset, KY
- NPI 1114951993
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1132704000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1263513600000",
"number": "1255314159",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 54",
"address_2": "728 WILBURN ROSS HWY",
"city": "STEARNS",
"state": "KY",
"postal_code": "426470054",
"telephone_number": "606-376-9544"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "71 MEDICAL LN",
"city": "WHITLEY CITY",
"state": "KY",
"postal_code": "426534216",
"telephone_number": "606-376-7212"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EMERSON-JOHNSON",
"first_name": "TAMMIE",
"middle_name": "L",
"credential": "FNP",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-11-23",
"last_updated": "2010-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "363L00000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner",
"state": "KY",
"license": "3202P",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "78004090",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Whitley City, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.