Active NPI
Karen Sue Tackett, PN
- Licensed Practical Nurse
- Waverly, OH
National Provider Identifier
1548492820
On this page
OIG exclusion record
The HHS Office of Inspector General’s List of Excluded Individuals/Entities (LEIE) contains a record with this NPI:
- Section 1128a(1) exclusion effective Oct 20, 2016.
Key facts
NPPES NPI Registry- Primary specialty
- Licensed Practical Nurse
- License
- PN.089531
- Practice address
- 198 Tackett Rd
Waverly, OH 45690-9785 - Phone
- (740) 222-4660
- NPI assigned
- Aug 20, 2009
- Last updated
- Aug 20, 2009
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Licensed Practical Nurse | 164W00000X | PN.089531 | OH | Primary |
Addresses
Primary practice location
198 Tackett Rd
Waverly, OH 45690-9785
Mailing address
198 Tackett LN
Waverly, OH 45690
Phone (740) 222-4660
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- Flagged The directory lists this NPI on an HHS exclusion list.
- Credentials
- Advanced Practice Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PN.089531 | OH | MD | Licensed Practical Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1250726400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1250726400000",
"number": "1548492820",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "198 TACKETT LN",
"city": "WAVERLY",
"state": "OH",
"postal_code": "45690",
"telephone_number": "740-222-4660"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 TACKETT RD",
"city": "WAVERLY",
"state": "OH",
"postal_code": "456909785",
"telephone_number": "740-222-4660"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "KAREN",
"middle_name": "SUE",
"name_prefix": "Mrs.",
"credential": "PN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2009-08-20",
"last_updated": "2009-08-20",
"status": "A"
},
"taxonomies": [
{
"code": "164W00000X",
"taxonomy_group": "",
"desc": "Licensed Practical Nurse",
"state": "OH",
"license": "PN.089531",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 20, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; OIG LEIE.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.