David Thomas Tackett, APRN | |
20 Medical Village Dr, Edgewood, KY 41017-5401 | |
(859) 578-5880 | |
(859) 578-5881 |
Full Name | David Thomas Tackett |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 4 Years |
Location | 20 Medical Village Dr, Edgewood, Kentucky |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1043821085 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 1136773 (Kentucky) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
St Elizabeth Edgewood | Edgewood, KY | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Summit Medical Group, Inc | 2163326240 | 712 |
Entity Name | Summit Medical Group, Inc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1508287640 PECOS PAC ID: 2163326240 Enrollment ID: O20031120000738 |
Mailing Address | Practice Location Address |
---|---|
David Thomas Tackett, APRN Po Box 635283, Cincinnati, OH 45263-5283 Ph: (859) 578-5880 | David Thomas Tackett, APRN 20 Medical Village Dr, Edgewood, KY 41017-5401 Ph: (859) 578-5880 |
Deborah Elaine Bliss, ACNP Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Village Drive, St. Elizabeth Healthcare, Edgewood, KY 41017 Phone: 859-301-2000 Fax: 859-301-6900 | |
Lyndsey Lang, MS, RN, NNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 Medical Village Dr, Edgewood, KY 41017 Phone: 859-301-2423 Fax: 859-301-2554 | |
Mrs. Anita Kay Phillips, ARNP-C Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1 Medical Village Dr, Edgewood, KY 41017 Phone: 859-301-8074 Fax: 859-301-4945 | |
Kristin Legrand, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Village Dr, Edgewood, KY 41017 Phone: 859-301-2250 | |
Louise M Cortland, APRN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1 Medical Village Dr, Edgewood, KY 41017 Phone: 859-757-2927 Fax: 859-341-0203 | |
Alexandra Michelle Wiesner, APRN Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1 Medical Village Dr, Edgewood, KY 41017 Phone: 859-301-2000 Fax: 859-426-4140 | |
Deanna Lynne Winter, CNP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 711 Medical Village Drive, Edgewood, KY 41017 Phone: 859-331-3353 Fax: 859-331-3326 |