Shelly A Tackett, OT

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

131137 Issued in KY

Practice address

1605 Scherm Rd Ste 1
Owensboro, KY 42301-5300

Phone

(270) 685-9499

Fax

(270) 685-9443

NPI assigned

Dec 11, 2019

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 KY

Enrollment records 1

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 and National Provider Directory roles.

• Progressive Sports Therapy, LLC.

  • Multi-Specialty Clinic/Center
  • Owensboro, KY
  • NPI 1538394424

  Occupational Therapist

  Medicare reassignment NPD

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1912545872",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 SCHERM RD STE 1",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423015300",
            "telephone_number": "270-685-9499",
            "fax_number": "270-685-9443"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 SCHERM RD STE 1",
            "city": "OWENSBORO",
            "state": "KY",
            "postal_code": "423015300",
            "telephone_number": "270-685-9499",
            "fax_number": "270-685-9443"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "SHELLY",
        "middle_name": "A",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "KY",
            "license": "131137",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Emily Sydow
• Jennifer L. Sylvester
• Sylvia Sweatt Family Practice,LLC
• Mitzi Szemethy, CRNA
• Thomas N. Tabb, M.D.
• William Tagg
• Crystal Tallent, OTR/L
• Tamberly McCoy, M.D. PLLC
• Matthew J Tandy, LPCC
• Kendall L Tapp, LPCC

• Occupational Therapist in Owensboro, KY
• Providers in Owensboro, KY by specialty
• Occupational Therapist in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.