Active NPI
Vickie Lynn Tackett, NURSE
- Registered Nurse
- Waverly, OH
National Provider Identifier
1760784961
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- RN-225283
- Practice address
- 2983 Buchanan Rd
Waverly, OH 45690-9223 - Phone
- (740) 947-7429
- Fax
- (749) 947-5679
- NPI assigned
- Nov 22, 2010
- Last updated
- Nov 22, 2010
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | RN-225283 | OH | Primary |
Addresses
Primary practice location
2983 Buchanan Rd
Waverly, OH 45690-9223
Mailing address
2983 Buchanan Road
Waverly, OH 45690
Phone (740) 947-7429
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RN-225283 | OH | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1290384000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1290384000000",
"number": "1760784961",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2983 BUCHANAN ROAD",
"city": "WAVERLY",
"state": "OH",
"postal_code": "45690",
"telephone_number": "740-947-7429",
"fax_number": "740-947-5679"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2983 BUCHANAN RD",
"city": "WAVERLY",
"state": "OH",
"postal_code": "456909223",
"telephone_number": "740-947-7429",
"fax_number": "749-947-5679"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TACKETT",
"first_name": "VICKIE",
"middle_name": "LYNN",
"credential": "NURSE",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2010-11-22",
"last_updated": "2010-11-22",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "OH",
"license": "RN-225283",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Waverly, OH
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 22, 2010; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.