Individual provider Active NPI

Tammy Elizabeth Jackson, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Frankfort, KY
National Provider Identifier
1669180717
Registry record updated Sep 15, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3018653 Issued in KY
Practice address
101 Medical Heights Dr Ste H
Frankfort, KY 40601-4137
Phone
(502) 385-0806
Fax
(502) 385-0656
NPI assigned
Nov 8, 2022
Last updated
Sep 15, 2026By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 15, 2026

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 3018653 KY Primary

Addresses

Primary practice location

101 Medical Heights Dr Ste H
Frankfort, KY 40601-4137

Mailing address

2955 Shadrick Ferry Rd
Frankfort, KY 40601-9476
Phone (502) 385-0806

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
I20230118002577 KY Practitioner - Nurse Practitioner 7719358332 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2022
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2955 Shadrick Ferry Rd
Frankfort, KY 40601-9476
Phone (502) 330-8522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
3018653KYMDPsychiatric/Mental Health Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Family Practice Clinic of Booneville, Inc. CurrentSince Dec 1, 2022 Accepting new patients
Mountain Family Practice Clinic of Manchester Inc CurrentSince Dec 1, 2022 Accepting new patients
Lancaster Family Health Care CurrentSince Dec 1, 2022 Accepting new patients
Capital City Psych & Mental Health Psychiatric/Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

200 Mulberry St
#A
Booneville, KY 41314
Phone (606) 596-0701

101 Medical Heights Dr
Ste H
Frankfort, KY 40601
Phone (502) 226-1522

101 Medical Heights Dr
Ste P
Frankfort, KY 40601
Phone (502) 235-5308

409 Holmes St
Frankfort, KY 40601

108 Lexington St
Lancaster, KY 40444
Phone (859) 304-5258

108 Manchester Shopping Ctr
Manchester, KY 40962
Phone (606) 596-0701

1012 Center Dr
Richmond, KY 40475
Phone (859) 626-9694

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3044/brand/1/csg/1/fhir/r4
  • Direct secure messaging: tammy.jackson.1@30911.direct.athenahealth.com

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": "1667865600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1789430400000",
    "number": "1669180717",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 SHADRICK FERRY RD",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406019476",
            "telephone_number": "502-385-0806"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "101 MEDICAL HEIGHTS DR STE H",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406014137",
            "telephone_number": "502-385-0806",
            "fax_number": "502-385-0656"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JACKSON",
        "first_name": "TAMMY",
        "middle_name": "ELIZABETH",
        "credential": "PMHNP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-11-08",
        "last_updated": "2026-09-15",
        "certification_date": "2026-09-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3018653",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

Verify at the official NPI Registry.