Individual provider Active NPI

Daniel Jay Tinney, APRN, PMHNP

  • Psychiatric/Mental Health Nurse Practitioner
  • Paris, KY
National Provider Identifier
1780329110
Registry record updated Apr 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
3017613 Issued in KY
Practice address
22 Clinic Dr
Paris, KY 40361-2161
Phone
(859) 987-0074
NPI assigned
Apr 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 29, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 3017613 KY Primary

Addresses

Primary practice location

22 Clinic Dr
Paris, KY 40361-2161

Mailing address

22 Clinic Dr
Paris, KY 40361-2161
Phone (859) 987-0074

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY
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
I20220810000153 KY Practitioner - Nurse Practitioner 1456734359 Reassigns benefits to 1 organization

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
Bourbon Physician Practice LLCGroup PAC ID 8729226097, 11 clinicians

Practice addresses (Care Compare)

18 Clinic Dr
Paris, KY 40361-2161
Phone (859) 987-5013

22 Clinic Dr
Paris, KY 40361-2161
Phone (859) 987-0074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Bourbon Physician Practice LLC Current Accepting new patients
Bourbon Physician Practice LLC CurrentSince Aug 1, 2022 Accepting new patients
Bourbon Physician Practice LLC CurrentSince Aug 1, 2022 Accepting new patients

Locations

1210 KY Highway 36 E
Cynthiana, KY 41031
Phone (859) 234-2300

1140 Lexington Rd
Ste 201
Georgetown, KY 40324
Phone (502) 570-3767

22 Clinic Dr
Paris, KY 40361
Phone (859) 987-0074

330 Seven Springs Way
Brentwood, TN 37027
Phone (615) 920-7780

Interoperability endpoints

  • Direct secure messaging: daniel.tinney.1@19475.direct.athenahealth.com
  • FHIR API: https://api.platform.athenahealth.com/19475/brand/10/csg/41/fhir/r4

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1651190400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651190400000",
    "number": "1780329110",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 CLINIC DR",
            "city": "PARIS",
            "state": "KY",
            "postal_code": "403612161",
            "telephone_number": "859-987-0074"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "22 CLINIC DR",
            "city": "PARIS",
            "state": "KY",
            "postal_code": "403612161",
            "telephone_number": "859-987-0074"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TINNEY",
        "first_name": "DANIEL",
        "middle_name": "JAY",
        "credential": "APRN, PMHNP",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-04-29",
        "last_updated": "2022-04-29",
        "certification_date": "2022-04-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "KY",
            "license": "3017613",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Paris, KY

Sources for this page

Verify at the official NPI Registry.