Joseph Brandon Tackett, FNP-C

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

903568 Issued in MS

Practice address

1051 Highland Colony Pkwy
Ridgeland, MS 39157-8843

Phone

(601) 707-3737

NPI assigned

Sep 14, 2019

Last updated

Oct 7, 2019By the provider in NPPES

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

Enrolled in MS

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

May accept Medicare assignment

Group practices

BW Medical LLCGroup PAC ID 0941653927, 7 clinicians

Trustcare Health, LLCGroup PAC ID 0547427858, 40 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: joseph.tackett.1@19538.direct.athenahealth.com

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.

• Trustcare Health, LLC

  dba Trust Care Health

  • Family Medicine Physician
  • Ridgeland, MS
  • NPI 1427338235
  Medicare reassignment Care Compare group NPD
• BW Medical LLC

  dba MS Express Health

  • Urgent Care Clinic/Center
  • Madison, MS
  • NPI 1538933742
  Medicare reassignment Care Compare group
• Trustcare Clinics, LLC

  • General Practice Physician
  • Ridgeland, MS
  • NPI 1821589318
  NPD (past)
• Trustcare Primary Care, LLC

  dba TrustCare Health, LLC

  • Family Medicine Physician
  • Madison, MS
  • NPI 1174078554
  NPD (past)

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

{
    "created_epoch": "1568419200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1570406400000",
    "number": "1811547532",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 HAMPTON PL",
            "city": "MADISON",
            "state": "MS",
            "postal_code": "391104546",
            "telephone_number": "601-260-2083"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1051 HIGHLAND COLONY PKWY",
            "city": "RIDGELAND",
            "state": "MS",
            "postal_code": "391578843",
            "telephone_number": "601-707-3737"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "JOSEPH",
        "middle_name": "BRANDON",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-09-14",
        "last_updated": "2019-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "903568",
            "primary": true
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "TACK-9YD0RY",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sweet Life Counseling LLC
• Caroline Swindoll
• Richard Paul Syner, RPT
• T Abeles & Co, Inc
• Elizabeth K Tackett, CCC-SLP
• Autumn B Tamor, OTD, OTR/L
• Maria Teresa Yap Tan, OTRL
• Johnson Dean Tanner, M.D.
• Laura Katherine Taranto
• Tonja M Tarvin, LCSW

• Family Nurse Practitioner in Ridgeland, MS
• Providers in Ridgeland, MS by specialty
• Family Nurse Practitioner in Mississippi

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 7, 2019; 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.