DR. JONATHAN KENTON TACKETT (NPI# 1407203888) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1407203888 |
| Entity Type | Individual |
| Full Name | DR. JONATHAN KENTON TACKETT |
| Credential | M.D. |
| Practice Address |
117 E Kings Hwy Eden NC 27288-5201 |
| Mailing Address |
5640 Marblehead Dr Colfax NC 27235-9801 |
| Practice Telephone | 3366239711 |
| Mailing Telephone | 5016761410 |
| Enumeration Date | 2016-05-16 |
| Last Update Date | 2020-04-03 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207P00000X | Emergency Medicine | 2019-01875 | NC | Allopathic & Osteopathic Physicians |
| N | 207P00000X | Emergency Medicine | E-10960 | AR | Allopathic & Osteopathic Physicians |
| Address | Telephone Number | Fax Number |
|---|---|---|
| 4010 S Mulberry St, Pine Bluff, AR 716037000 | 8705416000 | |
| 611 W Lee Ave, Osceola, AR 723703001 | 8705637000 | 8705637189 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1578908265 | Jonathan Tackett | Counselor | 1104 Foxwood Dr, Sevierville, TN 37862-6000 | 2013-05-08 |
| 1922369974 | Jonathan Mark Tackett | Family Medicine | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2012-06-06 |
| Street Address |
117 E KINGS HWY |
| City | EDEN |
| State | NC |
| Zip Code | 27288-5201 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1326048810 | Unc Rockingham Health Care, Inc. | General Acute Care Hospital | 117 E Kings Hwy, Eden, NC 27288-5201 | 2005-07-26 |
| 1629549852 | Jesse Robert Gustafson | Physician Assistant | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-12-16 |
| 1528545399 | Unc Rockingham Health Care, Inc. | Anesthesiology | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-07-25 |
| 1366929135 | Unc Rockingham Health Care, Inc. | Nurse Anesthetist, Certified Registered | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-07-25 |
| 1275010043 | Unc Rockingham Health Care, Inc. | Surgery | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-07-25 |
| 1710477849 | Mary Robertson Lafar | Physical Therapy Assistant | 117 E Kings Hwy, Eden, NC 27288-5201 | 2018-05-15 |
| 1174036495 | Melonie Deon Davis | Counselor | 117 E Kings Hwy, Eden, NC 27288-5201 | 2017-11-08 |
| 1457862963 | Katheryn Goodman Hubbard | Social Worker | 117 E Kings Hwy, Eden, NC 27288-5201 | 2017-10-24 |
| 1164886834 | Trey Washington | Occupational Therapist | 117 E Kings Hwy, Eden, NC 27288-5201 | 2016-04-08 |
| 1356706519 | Michael V Stehlik | Pharmacist | 117 E Kings Hwy, Eden, NC 27288-5201 | 2015-12-15 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639781297 | Bailey Shea Scism | Pharmacist | 103 W Stadium Dr., Eden, NC 27288 | 2020-08-17 |
| 1538640628 | Donnell Corey Brown Jr. | Technician | 519 Orchard Drive, Eden, NC 27288 | 2018-08-27 |
| 1851728182 | Linda Mitchell | Physical Therapy Assistant | 114 E Kings Hwy, Eden, NC 27288 | 2013-10-01 |
| 1033341573 | Central State of The Carolinas, Inc. | Day Training, Developmentally Disabled Services | 229 Cedar St., Eden, NC 27288 | 2009-08-18 |
| 1114186483 | Enrich Cosmetic Center | Internal Medicine | 406 B Thompson St, Eden, NC 27288 | 2008-06-03 |
| 1265630891 | John R. Dabbs Jr. Dc PC | Preferred Provider Organization | 405 Boone Road, Eden, NC 27288 | 2007-07-05 |
| 1235283961 | James Harrison Eggleston | Dentist | 113 West Arbor Lane, Eden, NC 27288 | 2007-01-22 |
| 1962563940 | Barbara Collins Tanner | Nurse Practitioner | 134 North Pierce Street, Morehead High School Student Health Center, Eden, NC 27288 | 2006-12-13 |
| 1285690974 | Robert Maurice Vaughn | Chiropractor | 405 Boone Rd, Eden, NC 27288 | 2006-04-22 |
| 1619930666 | Direct Respiratory Services | Durable Medical Equipment & Medical Supplies | 302a North Pierce Street, Eden, NC 27288 | 2006-04-10 |
| Find all providers in zip 27288 | ||||
| Taxonomy Code | 207P00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Emergency Medicine |
| An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: added definition, added source; 7/1/2011: mofified source] - Additional Resources: American Board of Emergency Medicine, 2007. http://www.abem.org/public/; American Osteopathic Board of Emergency Medicine, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Emergency Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Emergency Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1760828966 | Randall L. Sloan, D.o., Pllc | Emergency Medicine | 614 Eaker, Eden, TX 76837-0987 | 2013-05-14 |
| 1396984985 | Roy Robert Keys, PC | Emergency Medicine | 227 W Harris Pl, Eden, NC 27288-9502 | 2009-02-05 |
| 1891759171 | Ossian B. Wynn | Emergency Medicine | 117 E. Kings Highway, Eden, NC 27288-5201 | 2006-04-14 |
| 1518374800 | Nc Emergency Physician Services, Pllc | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2014-07-18 |
| 1932433877 | Gina Martin, M.d., P.l.l.c. | Emergency Medicine | 618 S Pierce St, Eden, NC 27288-5863 | 2009-09-24 |
| 1689889081 | Morehead Memorial Hospital | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2007-05-11 |
| 1245319227 | Jason Shih-ning Yuan | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-11-02 |
| 1356366462 | Gary Thomas Mutch | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-07-12 |
| 1275565681 | Roy Robert Keys | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-07-07 |
| 1770511123 | Christopher John Pollina | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2006-06-28 |
| Find all providers in EDEN | ||||
Please comment or provide details below to improve the information on DR. JONATHAN KENTON TACKETT.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.