Mary Ann Tackett, LPN

Primary specialty

Licensed Practical NurseTaxonomy code 164W00000X

License

PN127169-MEDS Issued in OH

Practice address

88 N. Sandusky St
Delaware, OH 43015

Phone

(740) 203-3800

Fax

(740) 203-3799

NPI assigned

Jul 19, 2016

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

Other names 1

• Mary Ann Tackett Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Maryhaven Inc

  • Addiction (Substance Use Disorder) Registered Nurse
  • Delaware, OH
  • NPI 1538676317
  NPD (past)
• Maryhaven Inc.

  • Community/Behavioral Health Agency
  • Columbus, OH
  • NPI 1245290436
  NPD (past)

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

{
    "created_epoch": "1468886400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468886400000",
    "number": "1881047447",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1791 ALUM CREEK DR",
            "city": "COLUMBUS",
            "state": "OH",
            "postal_code": "432071708",
            "telephone_number": "614-445-8131",
            "fax_number": "614-827-8380"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 N. SANDUSKY ST",
            "city": "DELAWARE",
            "state": "OH",
            "postal_code": "43015",
            "telephone_number": "740-203-3800",
            "fax_number": "740-203-3799"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "MARY",
        "middle_name": "ANN",
        "credential": "LPN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-07-19",
        "last_updated": "2016-07-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "164W00000X",
            "taxonomy_group": "",
            "desc": "Licensed Practical Nurse",
            "state": "OH",
            "license": "PN127169-MEDS",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MARY",
            "last_name": "TACKETT",
            "middle_name": "ANN",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Rhoda Marie Swape
• Katie Lee Swartz, FNP-BC
• Emily Lauren Sykes, MD
• T B F Inc
• Karen A. Tackett, APRN-CNP
• Marie BN Tanyi, CNP
• Erin Tarney, AU.D.
• Andrew Taylor
• Diana Lee Taylor, MD
• Rhonda Taylor

• Licensed Practical Nurse in Delaware, OH
• Providers in Delaware, OH by specialty
• Licensed Practical Nurse in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 19, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.