Individual provider Active NPI

Tabitha Jeanann Fleenor, APRN

  • Family Nurse Practitioner
  • Lexington, KY
National Provider Identifier
1609202837
Registry record updated Sep 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3008315 Issued in KY
Practice address
1060 Goodwin Dr Ste 110
Lexington, KY 40505-3824
Phone
(859) 288-2425
Fax
(859) 721-3918
NPI assigned
Sep 19, 2013
Last updated
Sep 23, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3008315 KY Primary

Addresses

Primary practice location

1060 Goodwin Dr Ste 110
Lexington, KY 40505-3824

Mailing address

496 Southland Dr
Lexington, KY 40503-1827
Phone (859) 288-2392

Other identifiers 1

IdentifierTypeStateIssuer
7100270600MedicaidKY

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
I20140311000880 KY Practitioner - Nurse Practitioner 0042440182 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
New Vista of the Bluegrass Inc CurrentSince Jun 13, 2022 Accepting new patients
New Vista of the Bluegrass CurrentSince Jun 13, 2022 Accepting new patients
Concertocare Medical Group of Tennessee, PC CurrentSince May 2, 2025 Accepting new patients
New Vista of the Bluegrass Inc Current Accepting new patients

Locations

1351 Newtown Pike
Bldg 1
Lexington, KY 40511
Phone (858) 253-1686

1351 Newtown Pike
Bldg 5
Lexington, KY 40511
Phone (859) 233-0444

3499 Blazer Pkwy
Ste 330
Lexington, KY 40509
Phone (410) 885-4727

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.

NPI Registry JSON

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

{
    "created_epoch": "1379548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727049600000",
    "number": "1609202837",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "496 SOUTHLAND DR",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405031827",
            "telephone_number": "859-288-2392",
            "fax_number": "859-721-3918"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1060 GOODWIN DR STE 110",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405053824",
            "telephone_number": "859-288-2425",
            "fax_number": "859-721-3918"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FLEENOR",
        "first_name": "TABITHA",
        "middle_name": "JEANANN",
        "name_prefix": "Mrs.",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-09-19",
        "last_updated": "2024-09-23",
        "certification_date": "2024-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3008315",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "7100270600",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Lexington, KY

Sources for this page

Verify at the official NPI Registry.