Kelly Jo Nicole Tackett, MD MPH

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

2025-01841 Issued in NC

Practice address

1119 Hendersonville Rd Ste 200
Asheville, NC 28803-6622

Phone

(828) 274-6003

NPI assigned

Apr 1, 2021

Last updated

Aug 25, 2025By 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 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NC

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Dermatology

Education

University of North Carolina at Chapel Hill School of Medicine, 2021

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Forest Dermatology PAGroup PAC ID 6709806946, 8 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Pardee Hospital Henderson County Hospital, Hendersonville, NC, CCN 340017

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: ktackett236118@direct.unc.nchie.net

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.

• Forest Dermatology, PA

  • Dermatology Physician
  • Asheville, NC
  • NPI 1396926507
  Medicare reassignment Care Compare group NPD

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

• Henderson County Hospital Corporation

  dba Margaret R. Pardee Memorial Hospital

  • General Acute Care Hospital
  • Hendersonville, NC
  • NPI 1144247982
  Care Compare affiliation

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

{
    "created_epoch": "1617235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1756080000000",
    "number": "1831777630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 90003",
            "city": "CHARLOTTE",
            "state": "NC",
            "postal_code": "282900003",
            "telephone_number": "828-845-8099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1119 HENDERSONVILLE RD STE 200",
            "city": "ASHEVILLE",
            "state": "NC",
            "postal_code": "288036622",
            "telephone_number": "828-274-6003"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1700 Asheville Hwy",
            "address_purpose": "LOCATION",
            "city": "Hendersonville",
            "state": "NC",
            "postal_code": "287912308",
            "country_code": "US",
            "telephone_number": "828-274-6003",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "KELLY JO",
        "middle_name": "NICOLE",
        "name_prefix": "Dr.",
        "credential": "MD MPH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-01",
        "last_updated": "2025-08-25",
        "certification_date": "2025-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "NC",
            "license": "2025-01841",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Szostczuk, D.C.
• Jennifer R Szypczak, DPM
• T. Luke Roberts, DMD, MSD, PA (Blue Ridge Orthodontics)
• Shannon Tabor, LPC
• Tabrah Telepsychiatry PLLC
• Tadeusz F. Poplawski MD PA
• Sydney Humphrey Tadvick
• Tailored Telehealth (Tailored Teletherapy)
• Jeffrey Tait, MBBS
• Madison Tallent, ARNP

• Dermatology Physician in Asheville, NC
• Providers in Asheville, NC by specialty
• Dermatology Physician in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2025; 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.