Orville C Tackett

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

3973 County Road 15
South Point, OH 45680-7593

Phone

(740) 414-8088

NPI assigned

Feb 11, 2021

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1613001600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613001600000",
    "number": "1407449366",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3973 COUNTY ROAD 15",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456807593",
            "telephone_number": "740-414-8088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3973 COUNTY ROAD 15",
            "city": "SOUTH POINT",
            "state": "OH",
            "postal_code": "456807593",
            "telephone_number": "740-414-8088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "ORVILLE",
        "middle_name": "C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-02-11",
        "last_updated": "2021-02-11",
        "certification_date": "2021-02-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Titus Stewart, MSW, LSW
• Shawn Daniel Stidham
• Kayla Dawn Sturgill
• Michelle Lee Sydoriak
• Anna Tackett
• Timothy Tackett
• Thomas Marion Tice
• Robert Todd, CDCA
• Tri-State Telemed LLC
• Allison Truitt

• Community Health Worker in South Point, OH
• Providers in South Point, OH by specialty
• Community Health Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.