Chandos Dewayne Tackett, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

18209 Issued in WV

Practice address

3075 US Route 60 Ste A110
Huntington, WV 25705-8859

Phone

(304) 528-4600

NPI assigned

Jun 22, 2006

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 4

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in WV

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

Family Practice

Education

JC Edwards School of Medicine, Marshall University, 1992

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

St. Mary'S Himg, LLCGroup PAC ID 8729406459, 80 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• St Mary'S Home Health Service Home health agency, Proctorville, OH, CCN 368269
• St Mary'S Home Health Service Home health agency, Huntington, WV, CCN 517055
• St Marys Medical Center Hospital, Huntington, WV, CCN 510007

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Interoperability endpoints

• Direct secure messaging: chandostackett@himg.directbygreenway.com

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.

• St. Mary'S Himg, LLC

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1184233454

  Family Medicine

  Medicare reassignment Care Compare group NPD
• St Marys Medical Center, Inc.

  • Internal Medicine Physician
  • Huntington, WV
  • NPI 1104681485
  NPD (past)
• Tsohns Inc

  • Otolaryngology Physician
  • Huntington, WV
  • NPI 1063503738
  NPD (past)
• Ultimate Health Services, Inc.

  • Durable Medical Equipment & Medical Supplies
  • Huntington, WV
  • NPI 1407946668
  NPD (past)
• Ultimate Health Services, Inc.

  • Ambulatory Surgical Clinic/Center
  • Proctorville, OH
  • NPI 1073764379
  NPD (past)

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

• St. Mary'S Medical Center Home Health Services, LLC

  • Home Health Agency
  • Huntington, WV
  • NPI 1073705539
  Care Compare affiliation
• St. Mary'S Medical Center Inc

  • General Acute Care Hospital
  • Huntington, WV
  • NPI 1164492195
  Care Compare affiliation
• St. Mary'S Medical Center Home Health Services, LLC

  • Home Health Agency
  • Proctorville, OH
  • NPI 1013109560
  Care Compare affiliation

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

{
    "created_epoch": "1150934400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745366400000",
    "number": "1912933151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3075 US ROUTE 60",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058859",
            "telephone_number": "304-528-4600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3075 US ROUTE 60 STE A110",
            "city": "HUNTINGTON",
            "state": "WV",
            "postal_code": "257058859",
            "telephone_number": "304-528-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "CHANDOS",
        "middle_name": "DEWAYNE",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-22",
        "last_updated": "2025-04-23",
        "certification_date": "2025-04-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "WV",
            "license": "18209",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0054285000",
            "state": "WV"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE OHIO",
            "identifier": "P00472743",
            "state": "OH"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0141822",
            "state": "OH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "080068402",
            "state": null
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ChandosTackett@himg.directbygreenway.com",
            "affiliation": "N",
            "address_1": "5170 US Rt 60 East",
            "city": "Huntington",
            "state": "WV",
            "country_code": "US",
            "postal_code": "25705",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Mumtaz B Syed, MD
• T & J Enterprises, Inc
• Carrie Tabor
• Amanda Tackett
• Brock Tackett
• Elizabeth Tackett
• Eva Patton Tackett, MD
• Kristy Tackett, OTR
• Kyle Tackett, PSY.D.
• Libertee Tackett

• Family Medicine Physician in Huntington, WV
• Providers in Huntington, WV by specialty
• Family Medicine Physician in West Virginia

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 23, 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.