Carlyn E Tackett, APRN

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

113970 Issued in OK

Practice address

16 S Water St
Sapulpa, OK 74066-4232

Phone

(918) 347-9022

NPI assigned

Feb 10, 2020

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

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

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Apex Wound Management LLC

  • Clinic/Center
  • Tulsa, OK
  • NPI 1740067727
  Medicare reassignment NPD
• Divine Health and Wellness, LLC

  • Health Service Clinic/Center
  • Sapulpa, OK
  • NPI 1790528164
  Medicare reassignment NPD
• Apex Wound Specialists LLC

  • Clinic/Center
  • Broken Arrow, OK
  • NPI 1902630122
  NPD

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713225600000",
    "number": "1720610587",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "16 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "918-947-9117"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "16 S WATER ST",
            "city": "SAPULPA",
            "state": "OK",
            "postal_code": "740664232",
            "telephone_number": "918-347-9022"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "CARLYN",
        "middle_name": "E",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-10",
        "last_updated": "2024-04-16",
        "certification_date": "2024-04-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "OK",
            "license": "0113970",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "OK",
            "license": "113970",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Swafford
• Riley Briar Swan
• Swipht Pharmacy Inc
• Swipht Pharmacy Inc
• Swipht Pharmacy LTC
• Tate Montgomery DDS PLC
• Barbara Y Taylor
• Cherron Nicole Taylor, FNP, AGACNP, DNP
• Karen Lan Taylor, CM-D,BA
• Kera Taylor

• Family Nurse Practitioner in Sapulpa, OK
• Providers in Sapulpa, OK by specialty
• Family Nurse Practitioner in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 16, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.