Individual provider Active NPI

Steven Michael Tackett, APRN

  • Acute Care Nurse Practitioner
  • Columbia, SC
National Provider Identifier
1750954418
Registry record updated Dec 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
F25200 Issued in SC
Practice address
1 Richland Medical Park Dr Ste 300
Columbia, SC 29203-6831
Phone
(803) 434-7910
Fax
(803) 933-3022
NPI assigned
Jul 21, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X F25200 SC Primary

Addresses

Primary practice location

1 Richland Medical Park Dr Ste 300
Columbia, SC 29203-6831

Mailing address

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2000

Other practice location 1

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2000

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address stackett110298@direct.lexmed.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in SC
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
I20210813002554 SC Practitioner - Nurse Practitioner 5294139143 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2021
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Prisma Health Medical Group-MidlandsGroup PAC ID 5991099707, 1,040 clinicians
Lexington Health IncGroup PAC ID 2567872070, 905 clinicians

Practice addresses (Care Compare)

1 Richland Medical Park Dr
Suite 300
Columbia, SC 29203-6831
Phone (803) 434-3320

2720 Sunset Blvd
West Columbia, SC 29169-4810
Phone (803) 791-2350

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.09 of 100Reported as group
Quality
68.87
Promoting interoperability
100
Improvement activities
40
Cost
78.11

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
F25200SCMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Lexington County Health Services District Inc Current Accepting new patients
Lexington Health Inc CurrentSince Aug 15, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 16, 2024 Accepting new patients
Lexington Health Inc CurrentSince Aug 15, 2021 Accepting new patients
Prisma Health Medical Group-Midlands CurrentSince Dec 16, 2024 Accepting new patients
Lexington Health Inc Current Accepting new patients

Locations

1333 Taylor St
Ste 6F
Columbia, SC 29201
Phone (803) 296-3273

100 Palmetto Health Pkwy
Ste G100
Columbia, SC 29212
Phone (803) 296-3273

1 Richland Medical Park Dr
Ste 300
Columbia, SC 29203
Phone (803) 434-7910

2 Medical Park Rd
Ste 506
Columbia, SC 29203
Phone (803) 434-3930

811 W Main St
Ste 101
Lexington, SC 29072
Phone (803) 936-7230

2720 Sunset Blvd
West Columbia, SC 29169
Phone (803) 791-2480

Interoperability endpoints

  • Direct secure messaging: stackett110298@direct.lexmed.com
  • Direct secure messaging: stackett826027@direct.ghs.myhfn.org

Organizations & group practices 6

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.

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": "1626825600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733184000000",
    "number": "1750954418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2720 SUNSET BLVD",
            "city": "WEST COLUMBIA",
            "state": "SC",
            "postal_code": "291694810",
            "telephone_number": "803-791-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1 RICHLAND MEDICAL PARK DR STE 300",
            "city": "COLUMBIA",
            "state": "SC",
            "postal_code": "292036831",
            "telephone_number": "803-434-7910",
            "fax_number": "803-933-3022"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2720 Sunset Blvd",
            "address_purpose": "LOCATION",
            "city": "West Columbia",
            "state": "SC",
            "postal_code": "291694810",
            "country_code": "US",
            "telephone_number": "803-791-2000",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "STEVEN",
        "middle_name": "MICHAEL",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-21",
        "last_updated": "2024-12-03",
        "certification_date": "2024-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "SC",
            "license": "F25200",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "stackett110298@direct.lexmed.com",
            "affiliation": "N",
            "address_1": "2720 Sunset Blvd",
            "city": "West Columbia",
            "state": "SC",
            "country_code": "US",
            "postal_code": "291694810",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Columbia, SC

Sources for this page

Verify at the official NPI Registry.