Individual provider Active NPI

Tina Holbrook, APRN

  • Family Nurse Practitioner
  • Richmond, KY
National Provider Identifier
1902350556
Registry record updated Aug 12, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
3010572 Issued in KY
Practice address
312 Jason Dr Ste 9
Richmond, KY 40475-2785
Phone
(859) 626-9696
NPI assigned
Aug 12, 2016
Last updated
Aug 12, 2016By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 12, 2016

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 3010572 KY Primary
Critical Care Medicine Registered Nurse 163WC0200X 1109689 KY

Addresses

Primary practice location

312 Jason Dr Ste 9
Richmond, KY 40475-2785

Mailing address

149 Pineur Rd
Richmond, KY 40475-9152
Phone (859) 200-9747

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
I20161021001960 KY Practitioner - Nurse Practitioner 0042598245 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Baptist Health Medical Group IncGroup PAC ID 5597867184, 2,431 clinicians

Practice addresses (Care Compare)

1 Trillium Way
Corbin, KY 40701-8420
Phone (606) 523-1934

Merit-based Incentive Payment System (MIPS)

Final score
94.29 of 100Reported as apm
Quality
87.32
Promoting interoperability
100
Improvement activities
40

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1109689KYMDCritical Care Medicine Registered Nurse
3010572KYMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Family Practice Clinic of Booneville, Inc. CurrentSince Sep 22, 2018 Accepting new patients
Baptist Health Medical Group Inc Current Accepting new patients
Mountain Family Practice Clinic of Manchester Inc CurrentSince Sep 22, 2018 Accepting new patients
Ethan Health LLC CurrentSince Aug 5, 2018 Accepting new patients
Baptist Health Medical Group Inc CurrentSince Dec 1, 2021 Accepting new patients
Richmond Family Medicine Associates Past Accepting new patients
Lancaster Family Health Care Past Accepting new patients

Locations

200 Mulberry St
#A
Booneville, KY 41314
Phone (606) 596-0701

1 Trillium Way
Corbin, KY 40701
Phone (606) 523-8521

4071 Tates Creek Centre Dr
Ste 202
Lexington, KY 40517
Phone (859) 260-4390

108 Manchester Shopping Ctr
Manchester, KY 40962
Phone (606) 596-0701

1623 Foxhaven Dr
Richmond, KY 40475
Phone (859) 625-5235

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/3044/brand/1/csg/1/fhir/r4

Organizations & group practices 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1470960000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1470960000000",
    "number": "1902350556",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "149 PINEUR RD",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404759152",
            "telephone_number": "859-200-9747"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "312 JASON DR STE 9",
            "city": "RICHMOND",
            "state": "KY",
            "postal_code": "404752785",
            "telephone_number": "859-626-9696"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HOLBROOK",
        "first_name": "TINA",
        "credential": "APRN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-08-12",
        "last_updated": "2016-08-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "KY",
            "license": "3010572",
            "primary": true
        },
        {
            "code": "163WC0200X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Critical Care Medicine",
            "state": "KY",
            "license": "1109689",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Richmond, KY

Sources for this page

Verify at the official NPI Registry.