Individual provider Active NPI

Tiffany Lynn Richardson, ARNP

  • Nurse Practitioner
  • Elizabethtown, KY
National Provider Identifier
1275787053
Registry record updated Nov 8, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
5799P Issued in KY
Practice address
1107 Crown Pointe Dr
Suite C
Elizabethtown, KY 42701-7123
Phone
(270) 982-1200
Fax
(270) 234-1952
NPI assigned
Nov 6, 2008
Last updated
Nov 8, 2013By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 8, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 5799P KY Primary

Addresses

Primary practice location

1107 Crown Pointe Dr
Suite C
Elizabethtown, KY 42701-7123

Mailing address

PO Box 2119
Elizabethtown, KY 42702-2119
Phone (270) 982-1200

Other identifiers 2

IdentifierTypeStateIssuer
7100064850MedicaidKY
000000593282OtherANTHEM BCBS

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
I20081231000390 KY Practitioner - Nurse Practitioner 1355403239 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Louisville School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

2406 Ring Rd
Elizabethtown, KY 42701-7940
Phone (270) 234-8866

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5799PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc Nurse Practitioner CurrentSince Sep 1, 2020 Accepting new patients
Baptist Health Medical Group Inc Nurse Practitioner Current Accepting new patients
Baptist Health Medical Group Inc CurrentSince Sep 1, 2020 Accepting new patients
Hardin Professional Services Past Accepting new patients

Locations

2406 Ring Rd
Elizabethtown, KY 42701
Phone (270) 234-8866

913 N Dixie Ave
Elizabethtown, KY 42701
Phone (270) 706-1212

2603 Kentucky Ave
Ste 304
Paducah, KY 42003
Phone (270) 415-4800

Organizations & group practices 4

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.

Hospital & facility affiliations 2

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": "1225929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1383868800000",
    "number": "1275787053",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2119",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427022119",
            "telephone_number": "270-982-1200",
            "fax_number": "270-234-1952"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1107 CROWN POINTE DR",
            "address_2": "SUITE C",
            "city": "ELIZABETHTOWN",
            "state": "KY",
            "postal_code": "427017123",
            "telephone_number": "270-982-1200",
            "fax_number": "270-234-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RICHARDSON",
        "first_name": "TIFFANY",
        "middle_name": "LYNN",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-06",
        "last_updated": "2013-11-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "5799P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100064850",
            "state": "KY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BCBS",
            "identifier": "000000593282",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Elizabethtown, KY

Sources for this page

Verify at the official NPI Registry.