Individual provider Active NPI

Katherine Leann Tackett, D.O.

  • Family Medicine Physician
  • Prestonsburg, KY
National Provider Identifier
1992115562
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
04007 Issued in KY
Practice address
1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Phone
(606) 886-1260
Fax
(606) 886-3590
NPI assigned
May 5, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 04007 KY Primary

Addresses

Primary practice location

1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889

Mailing address

PO Box 1595
Ashland, KY 41105-1595
Phone (606) 408-6200

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170913000396 KY Practitioner - Family Practice 5395018394 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
University of Pikeville, Kentucky College of Osteopathic Med, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ashland Hospital CorporationGroup PAC ID 7719882521, 169 clinicians

Practice addresses (Care Compare)

1279 Old Abbott Mountain Rd
Prestonsburg, KY 41653-1889
Phone (606) 886-1260

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
89.16 of 100Reported as group
Quality
77.42
Promoting interoperability
100
Improvement activities
40
Cost
77.62

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

Practice roles

OrganizationSpecialtyStatusNew patients
Ashland Hospital Corporation Family Medicine CurrentSince Sep 11, 2017 Accepting new patients
Ashland Hospital Corporation CurrentSince Sep 11, 2017 Accepting new patients
Ashland Hospital Corporation Family Medicine Current Accepting new patients
Ashland Hospital Corporation Current Accepting new patients
Ashland Hospital Corporation Family Medicine Past Accepting new patients

Locations

10650 US Route 60
Ashland, KY 41102
Phone (606) 408-6301

12100 Princeland Spur
Ashland, KY 41102
Phone (606) 928-2963

2201 Lexington Ave
Ashland, KY 41101
Phone (606) 268-2560

354 N Mayo Trl
Paintsville, KY 41240
Phone (606) 372-0221

Interoperability endpoints

  • Direct secure messaging: ktackett64845@direct.kdhealth.us

Organizations & group practices 5

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.

Hospital & facility affiliations 1

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

NPI Registry JSON

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

{
    "created_epoch": "1399248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1992115562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1595",
            "city": "ASHLAND",
            "state": "KY",
            "postal_code": "411051595",
            "telephone_number": "606-408-6200",
            "fax_number": "606-408-6612"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1279 OLD ABBOTT MOUNTAIN RD",
            "city": "PRESTONSBURG",
            "state": "KY",
            "postal_code": "416531889",
            "telephone_number": "606-886-1260",
            "fax_number": "606-886-3590"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TACKETT",
        "first_name": "KATHERINE",
        "middle_name": "LEANN",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-05-05",
        "last_updated": "2022-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "04007",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Prestonsburg, KY

Sources for this page

Verify at the official NPI Registry.