James Faird Tackett, MD

Primary specialty

Emergency Medicine PhysicianTaxonomy code 207P00000X

License

ME107562 Issued in FL

Practice address

221 NE Glen Oak Ave
Peoria, IL 61636-0001

Phone

(309) 999-1091

NPI assigned

Aug 13, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 5

Addresses

Other identifiers 3

Medicare fee-for-service enrollment

Enrolled in WV, FL, WY, AL, SC5 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 5

Specialty

Hospitalist

Education

West Virginia School of Osteopathic Medicine, 1993

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Houston County Healthcare AuthorityGroup PAC ID 9436062296, 256 clinicians

Galen Inpatient Physicians PCGroup PAC ID 3678464633, 1,045 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Ascension Sacred Heart Bay Hospital, Panama City, FL, CCN 100026
• Ascension Sacred Heart Gulf Hospital, Port Saint Joe, FL, CCN 100313
• Southeast Health Medical Center Hospital, Dothan, AL, CCN 010001
• Sacred Heart Hospital on the Emerald Coast Hospital, Miramar Beach, FL, CCN 100292
• Northwest Florida Community Hospital Hospital, Chipley, FL, CCN 101308

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: jtackett1206608@valleyhealth.direct-ci.com

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Pensacola, FL
  • NPI 1205614336
  Medicare reassignment Care Compare group NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Enterprise, AL
  • NPI 1619026606
  Medicare reassignment Care Compare group NPD
• Hospitalist Medicine Physicians of West Virginia, PLLC

  • Internal Medicine Physician
  • Wheeling, WV
  • NPI 1649575101
  Medicare reassignment NPD
• Memorial Hospital of Sweetwater County

  • Critical Access Hospital
  • Rock Springs, WY
  • NPI 1558361949
  Medicare reassignment NPD
• Sound Physicians of Wyoming, LLC

  • Hospitalist Physician
  • Casper, WY
  • NPI 1982982708

  Internal Medicine

  Medicare reassignment NPD
• Glutality Provider Group, P.a.

  • Internal Medicine Physician
  • Boca Raton, FL
  • NPI 1083256168

  SC, WV

  Medicare reassignment
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Los Angeles, CA
  • NPI 1205787686
  NPD
• Galen Inpatient Physicians PC

  • Hospitalist Physician
  • Miramar Beach, FL
  • NPI 1225816069
  NPD
• Houston County Healthcare Authority

  • Internal Medicine Physician
  • Dothan, AL
  • NPI 1538597349
  NPD
• Princeton Community Hospital Assn Inc.

  • Urology Physician
  • Princeton, WV
  • NPI 1093917643
  NPD
• Princeton Community Hospital Assn., Inc

  • Rural Health Clinic/Center
  • Bluefield, VA
  • NPI 1235446485
  NPD
• Comprehensive Emergency Solutions SC

  • Emergency Medicine Physician
  • Peoria, IL
  • NPI 1477515393
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ascension Sacred Heart Emerald Coast

  • General Acute Care Hospital
  • Miramar Beach, FL
  • NPI 1558391771
  Care Compare affiliation
• Ascension Sacred Heart Gulf

  • Rural Acute Care Hospital
  • Port St Joe, FL
  • NPI 1083941678
  Care Compare affiliation
• Bay County Health System, LLC

  • General Acute Care Hospital
  • Panama City, FL
  • NPI 1720078041
  Care Compare affiliation
• Houston County Healthcare Authority

  • General Acute Care Hospital
  • Dothan, AL
  • NPI 1164403861
  Care Compare affiliation
• Northwest Florida Healthcare, Inc

  • Critical Access Hospital
  • Chipley, FL
  • NPI 1336163708
  Care Compare affiliation

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

{
    "created_epoch": "1155427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743984000000",
    "number": "1699787804",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "RR 1 BOX 46-25",
            "city": "RED HOUSE",
            "state": "WV",
            "postal_code": "251689713",
            "telephone_number": "304-586-0915"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "221 NE GLEN OAK AVE",
            "city": "PEORIA",
            "state": "IL",
            "postal_code": "616360001",
            "telephone_number": "309-999-1091"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JAMES",
        "middle_name": "FAIRD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-13",
        "last_updated": "2025-04-07",
        "certification_date": "2025-04-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AL",
            "license": "MD.30275",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WY",
            "license": "TL7008",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "IL",
            "license": "036-117166",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "WV",
            "license": "7956",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "FL",
            "license": "ME107562",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "036117166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "36117166",
            "state": "IL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MCARE",
            "identifier": "P00376164",
            "state": "IL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Synergy Center for Integrative Health PC
• James G. Szudera, D.O.
• Thomas Szymke, MD
• T Chiropractic, LLC
• Leah Tabor
• Pramod Tadakamalla, DDS
• Zahra Tahir, OD
• Sameh Taki Aldin, MD
• Deliah Talbert
• Eulogio I Talili, PT

• Emergency Medicine Physician in Peoria, IL
• Providers in Peoria, IL by specialty
• Emergency Medicine Physician in Illinois

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 7, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.