Organization Active NPI

Capital City Psych & Mental Health

  • Psychiatric/Mental Health Nurse Practitioner
  • Frankfort, KY
National Provider Identifier
1972367076
Registry record updated Mar 31, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
Legal business name
CAPITAL CITY PSYCH & MENTAL HEALTH
Practice address
409 Holmes St
Frankfort, KY 40601-2209
Phone
(502) 385-0806
Fax
(502) 385-0656
NPI assigned
Feb 8, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 31, 2025

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

Authorized official

Name
Tammy Elizabeth Jackson, APRNNPI 1669180717
Title
Owner
Phone
(502) 385-0806

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse PractitionerGroup: 193400000X SINGLE SPECIALTY GROUP 363LP0808X Primary

Addresses

Primary practice location

409 Holmes St
Frankfort, KY 40601-2209

Mailing address

2955 Shadrick Ferry Rd
Frankfort, KY 40601-9476
Phone (502) 330-8522

Other practice location 1

2955 Shadrick Ferry Rd
Frankfort, KY 40601-9476
Phone (502) 330-8522

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in KY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20240916001701 KY Part B Supplier - Clinic/Group Practice 7214478445 Receives reassigned benefits from 1 practitioner
Practice locations: Frankfort, KY

National Provider Directory

National Provider Directory

Locations

409 Holmes St
Frankfort, KY 40601
Phone (502) 385-0806

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1707350400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743379200000",
    "number": "1972367076",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2955 SHADRICK FERRY RD",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406019476",
            "telephone_number": "502-330-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 HOLMES ST",
            "city": "FRANKFORT",
            "state": "KY",
            "postal_code": "406012209",
            "telephone_number": "502-385-0806",
            "fax_number": "502-385-0656"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2955 Shadrick Ferry Rd",
            "address_purpose": "LOCATION",
            "city": "Frankfort",
            "state": "KY",
            "postal_code": "406019476",
            "country_code": "US",
            "telephone_number": "502-330-8522",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CAPITAL CITY PSYCH & MENTAL HEALTH",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-02-08",
        "last_updated": "2025-03-31",
        "certification_date": "2025-03-31",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "TAMMY",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "502-385-0806",
        "authorized_official_credential": "APRN"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Frankfort, KY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 31, 2025; 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.