Chadwick Trei Tackett, MSN, FNP

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013650 Issued in KY

Practice address

230 W Main St
Lexington, KY 40507-1340

Phone

(859) 309-4839

NPI assigned

Apr 8, 2019

Sex

Male

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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Master of Science - Nursing

State licenses

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

{
    "created_epoch": "1554681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643932800000",
    "number": "1760945729",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "728 FITZROY LN",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405156354",
            "telephone_number": "606-255-7466"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "230 W MAIN ST",
            "city": "LEXINGTON",
            "state": "KY",
            "postal_code": "405071340",
            "telephone_number": "859-309-4839"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "CHADWICK",
        "middle_name": "TREI",
        "credential": "MSN, FNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-04-08",
        "last_updated": "2022-02-04",
        "certification_date": "2022-02-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "KY",
            "license": "1135877",
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013650",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Dana Szili, AUD
• Sanam Tabatabai, DO
• Jessica Lea Tabor, CRNA
• Melissa Tabor
• Amy E Tackett, PHARM D
• Jessica Faith Tackett, PHARMD
• Jim R Tackett, PA-C
• Kayce Ann Tackett, MD
• Kimberly Dawn Tackett, LMT
• Madison Bailey Tackett, MD

• Family Nurse Practitioner in Lexington, KY
• Providers in Lexington, KY by specialty
• Family Nurse Practitioner in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 4, 2022; 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.