Individual provider Active NPI

Tammy B Harris, ARNP

  • Nurse Practitioner
  • Campbellsville, KY
National Provider Identifier
1659434280
Registry record updated Jan 19, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
3673P Issued in KY
Practice address
67 Kingswood Dr
Suite 95
Campbellsville, KY 42718-9647
Phone
(270) 465-3812
Fax
(270) 465-8352
NPI assigned
Dec 18, 2006
Last updated
Jan 19, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 19, 2016

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 3673P KY Primary

Addresses

Primary practice location

67 Kingswood Dr
Suite 95
Campbellsville, KY 42718-9647

Mailing address

67 Kingswood Dr
Suite 95
Campbellsville, KY 42718-9647
Phone (270) 465-3812

Other identifiers 2

IdentifierTypeStateIssuer
50002936OtherKYPASSPORT
78007051MedicaidKY

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
I20040512001227 KY Practitioner - Nurse Practitioner 4486644523 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices

Practice addresses (Care Compare)

95 Kingswood Dr
Campbellsville, KY 42718-9604
Phone (270) 465-3812

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
73.96 of 100Reported as group
Quality
62.41
Promoting interoperability
69
Improvement activities
40
Cost
71.3

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
3673PKYMDNurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Taylor Regional Medical Group LLC CurrentSince Jul 1, 2015 Accepting new patients
Taylor Regional Medical Group, LLC CurrentSince Jul 1, 2015 Accepting new patients
University Surgical Associates, PSC Nurse Practitioner Past Accepting new patients

Locations

67 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 465-2116

95 Kingswood Dr
Campbellsvlle, KY 42718
Phone (270) 465-3812

Organizations & group practices 3

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 1

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": "1166400000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1453161600000",
    "number": "1659434280",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "67 KINGSWOOD DR",
            "address_2": "SUITE 95",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189647",
            "telephone_number": "270-465-3812",
            "fax_number": "270-465-8352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "67 KINGSWOOD DR",
            "address_2": "SUITE 95",
            "city": "CAMPBELLSVILLE",
            "state": "KY",
            "postal_code": "427189647",
            "telephone_number": "270-465-3812",
            "fax_number": "270-465-8352"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HARRIS",
        "first_name": "TAMMY",
        "middle_name": "B",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-12-18",
        "last_updated": "2016-01-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "KY",
            "license": "3673P",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PASSPORT",
            "identifier": "50002936",
            "state": "KY"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "78007051",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Campbellsville, KY

Sources for this page

Verify at the official NPI Registry.