Organization Active NPI

Tripco Medical LLC

  • Family Nurse Practitioner
  • Hopkinsville, KY
National Provider Identifier
1770016941
Registry record updated Apr 26, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
Legal business name
TRIPCO MEDICAL LLC
Practice address
111 Derrick PL
Hopkinsville, KY 42240-1325
Phone
(270) 874-2629
Fax
(270) 874-2774
NPI assigned
Apr 5, 2017
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 26, 2018

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

Authorized official

Name
Autumn Triplett, APRNNPI 1235439183
Title
Owner
Phone
(270) 632-4515

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LF0000X Primary

Addresses

Primary practice location

111 Derrick PL
Hopkinsville, KY 42240-1325

Mailing address

111 Derrick PL
Hopkinsville, KY 42240-1325
Phone (270) 874-2629

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20170419001864 KY Part B Supplier - Clinic/Group Practice 9830475201 Receives reassigned benefits from 2 practitioners
Practice locations: Hopkinsville, KY

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
18D2127957Tripco Medical111 Derrick St, Hopkinsville, KY 42240Certificate of waiverMar 21, 2027

National Provider Directory

National Provider Directory

Locations

111 Derrick Pl
Hopkinsville, KY 42240
Phone (270) 874-2629

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1491350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1524700800000",
    "number": "1770016941",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 DERRICK PL",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401325",
            "telephone_number": "270-874-2629",
            "fax_number": "270-874-2774"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "111 DERRICK PL",
            "city": "HOPKINSVILLE",
            "state": "KY",
            "postal_code": "422401325",
            "telephone_number": "270-874-2629",
            "fax_number": "270-874-2774"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TRIPCO MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-04-05",
        "last_updated": "2018-04-26",
        "status": "A",
        "authorized_official_last_name": "TRIPLETT",
        "authorized_official_first_name": "AUTUMN",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "270-632-4515",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hopkinsville, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.