Angela Tackett, NP

Primary specialty

Nurse PractitionerTaxonomy code 363L00000X

License

00063 Issued in OH

Practice address

8770 Ohio River Rd
Wheelersburg, OH 45694-1918

Phone

(740) 574-9090

NPI assigned

Jun 14, 2006

Sex

Female

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 OH

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

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Practitioner, Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: angela.tackett.1@17140.direct.athenahealth.com
• Direct secure messaging: angela.tackett.1@17066.direct.athenahealth.com

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.

• Epmg of Ohio Inc P a

  • Emergency Medicine Physician
  • Portsmouth, OH
  • NPI 1841232196

  Nurse Practitioner

  Medicare reassignment NPD

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

{
    "created_epoch": "1150243200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1212451200000",
    "number": "1255375184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 GREEN RD",
            "address_2": "SUITE 300",
            "city": "ANN ARBOR",
            "state": "MI",
            "postal_code": "481051598",
            "telephone_number": "734-995-3764"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8770 OHIO RIVER RD",
            "city": "WHEELERSBURG",
            "state": "OH",
            "postal_code": "456941918",
            "telephone_number": "740-574-9090"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "ANGELA",
        "credential": "NP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-06-14",
        "last_updated": "2008-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "OH",
            "license": "00063",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brittney Stout
• Travis B Stringer
• Stultz Pharmacy of Wheelersburg Inc
• Stultz Pharmacy of Wheelersburg, Inc
• Katrina Renee Sullivan, LPN
• Gregory Tackett
• Kayla M Tackett, NP-C
• Katie Talbert
• Talk Time Speech Therapy LLC
• Avery Taylor

• Nurse Practitioner in Wheelersburg, OH
• Providers in Wheelersburg, OH by specialty
• Nurse Practitioner in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2008; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.