Jessica Renee Tackett, NP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

3013573 Issued in KY

Practice address

571 Parkway Dr
Salyersville, KY 41465-9248

Phone

(606) 349-6181

NPI assigned

Jul 14, 2019

Last updated

Mar 30, 2020By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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

Specialty

Nurse Practitioner

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Extended Care Specialists, IncGroup PAC ID 2466407713, 295 clinicians

Eventus Wholehealth Midwest IncGroup PAC ID 4183040470, 120 clinicians

Ultacare Medical PLLCGroup PAC ID 4789687484, 52 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pikeville Medical Center Hospital, Pikeville, KY, CCN 180044

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Eventus Wholehealth Midwest Inc

  • Family Medicine Physician
  • Columbus, IN
  • NPI 1386252757

  KY

  Medicare reassignment Care Compare group NPD
• Extended Care Specialists, Inc

  • Adult Medicine Physician
  • Merrillville, IN
  • NPI 1134146079

  Family, KY

  Medicare reassignment Care Compare group NPD
• Ultacare Medical PLLC

  dba Dr. Hasemeier & Associates

  • Family Medicine Physician
  • New Tazewell, TN
  • NPI 1225141492

  KY

  Medicare reassignment Care Compare group NPD
• Eventus Ecs, Inc

  • Nurse Practitioner
  • Indianapolis, IN
  • NPI 1073353496

  KY

  Medicare reassignment NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Pikeville Medical Center Inc

  • General Acute Care Hospital
  • Pikeville, KY
  • NPI 1285621623
  Care Compare affiliation

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

{
    "created_epoch": "1563062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1585526400000",
    "number": "1801448444",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 143",
            "city": "SHELBIANA",
            "state": "KY",
            "postal_code": "415620143",
            "telephone_number": "859-537-2311"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 PARKWAY DR",
            "city": "SALYERSVILLE",
            "state": "KY",
            "postal_code": "414659248",
            "telephone_number": "606-349-6181"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JESSICA",
        "middle_name": "RENEE",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-14",
        "last_updated": "2020-03-30",
        "certification_date": "2020-03-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3013573",
            "primary": true
        },
        {
            "code": "163WG0000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, General Practice",
            "state": "KY",
            "license": "3013573",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "KENTUCKY BOARD OF NURSING",
            "identifier": "3013573",
            "state": "KY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Mary Grace Skeans, MA
• Melissa Gay Slone, LPCC
• Zacharry F Slone, DC
• Brian Sperger, MS., RD., LD.
• David Franklin Strahley, PH.D
• Maria Tackett, APRN
• Tranquility Care LLC
• Amanda Walden, RBT
• Walgreen Co (Walgreens #19545)
• Alicia Montgomery Ward, PHARMD

• Family Nurse Practitioner in Salyersville, KY
• Providers in Salyersville, 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 Mar 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.