Individual provider Active NPI

Tabitha Myers, APRN-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Salem, KY
National Provider Identifier
1396828596
Registry record updated Jul 18, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
5022P Issued in KY
Practice address
129 W Main St
Salem, KY 42078-8065
Phone
(270) 988-2675
Fax
(270) 988-2929
NPI assigned
Oct 23, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 18, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 5022P KY Primary

Addresses

Primary practice location

129 W Main St
Salem, KY 42078-8065

Mailing address

129 W Main St
Salem, KY 42078-8065
Phone (270) 988-2675

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
I20070623000001 KY Practitioner - Nurse Practitioner 9537268073 Reassigns benefits to 4 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
5022PKYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Trigg County Hospital, Inc Current Accepting new patients
Trigg County Hospital, Inc CurrentSince Jun 1, 2017 Accepting new patients
Trigg County Hospital, Inc CurrentSince Jun 1, 2017 Accepting new patients

Locations

254 Main St
Cadiz, KY 42211
Phone (270) 522-3215

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1161561600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1342569600000",
    "number": "1396828596",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "129 W MAIN ST",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420788065",
            "telephone_number": "270-988-2675",
            "fax_number": "270-988-2929"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "129 W MAIN ST",
            "city": "SALEM",
            "state": "KY",
            "postal_code": "420788065",
            "telephone_number": "270-988-2675",
            "fax_number": "270-988-2929"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MYERS",
        "first_name": "TABITHA",
        "credential": "APRN-BC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-23",
        "last_updated": "2012-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "5022P",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salem, KY

Sources for this page

Verify at the official NPI Registry.