Roberta Tackett, APRN, RN

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

3002865 Issued in KY

Practice address

1203 American Greeting Rd
Corbin, KY 40701-4811

Phone

(606) 528-7010

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

State licenses

Practice roles

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.

• Mountain Comprehensive Care Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Paintsville, KY
  • NPI 1699386078
  NPD (past)

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

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1301356800000",
    "number": "1710104716",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 568",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407020568"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1203 AMERICAN GREETING RD",
            "city": "CORBIN",
            "state": "KY",
            "postal_code": "407014811",
            "telephone_number": "606-528-7010"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "ROBERTA",
        "credential": "APRN, RN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2011-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3002865",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nanci Sutton
• Amanda Swafford, M.A.,CCC/SLP
• Jensen Sweet, RN,BSN
• Jeremy Swiney, MD
• Megan Jade Tackett, OTR/L
• Stephen Tackett, D.M.D.
• Sheila H Talley, LMFT
• Jessica Nicole Tanner, PHARMD
• Larry Tate, LDO
• Taylor and Clifton Family Healthcare

• Psychiatric/Mental Health Nurse Practitioner in Corbin, KY
• Providers in Corbin, KY by specialty
• Psychiatric/Mental Health Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.