JONATHAN MARK TACKETT (NPI# 1922369974) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1922369974 |
| Entity Type | Individual |
| Full Name | JONATHAN MARK TACKETT |
| Credential | D.O. |
| Practice Address |
1279 Old Abbott Mountain Rd Prestonsburg KY 41653-1889 |
| Mailing Address |
Po Box 1595 Ashland KY 41105-1595 |
| Practice Telephone | 6068861260 |
| Practice Fax Number | 6068863590 |
| Mailing Telephone | 6064086200 |
| Mailing Fax Number | 6064086612 |
| Enumeration Date | 2012-06-06 |
| Last Update Date | 2017-02-07 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207Q00000X | Family Medicine | 03794 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 7100406690 | 05 | |
| OH | 0160277 | 05 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407203888 | Jonathan Kenton Tackett | Emergency Medicine | 117 E Kings Hwy, Eden, NC 27288-5201 | 2016-05-16 |
| 1578908265 | Jonathan Tackett | Counselor | 1104 Foxwood Dr, Sevierville, TN 37862-6000 | 2013-05-08 |
| Street Address |
1279 OLD ABBOTT MOUNTAIN RD |
| City | PRESTONSBURG |
| State | KY |
| Zip Code | 41653-1889 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1790788180 | James A Dalton | Physician Assistant | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653 | 2005-05-31 |
| 1366094195 | David Seth Adams | Physician Assistant | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653 | 2019-07-11 |
| 1396206470 | Gabriel Smith | Nurse Practitioner | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2019-03-29 |
| 1992115562 | Katherine Leann Tackett | Family Medicine | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2014-05-05 |
| 1821357070 | Ashley Jo Bostic Adams | Family Medicine | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2012-05-09 |
| 1184943821 | Clayton Victor Bowman | Family Medicine | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2010-05-20 |
| 1710215736 | Kings Daughters Medical Specialties Inc | Physical Medicine & Rehabilitation | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2009-12-02 |
| 1487738720 | Scott R Akers | Physical Medicine & Rehabilitation | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2006-10-24 |
| 1609988989 | Patrick Keeley | Physical Medicine & Rehabilitation | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2006-08-31 |
| 1871518241 | John Rowe Furcolow | Internal Medicine | 1279 Old Abbott Mountain Rd, Prestonsburg, KY 41653-1889 | 2006-07-13 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1568094670 | Commonwealth Community Care Centers, LLC | Obstetrics & Gynecology | 156 North Lake Drive, Prestonburg, KY 41653 | 2020-02-06 |
| 1336781152 | Toni Coleman | Counselor | 104 South Front Ave, Prestonsburg, KY 41653 | 2019-10-14 |
| 1063070043 | Beverly Jane Daniel | Nurse Practitioner | 5230-ky-321#8, Prestonsburg, KY 41653 | 2019-06-04 |
| 1760966519 | Mackenzie Alvarez | Counselor | 104 South Front Avenue, Prestonsburg, KY 41653 | 2018-09-18 |
| 1427409739 | Css Rehab Services | Early Intervention Provider Agency | 165 Ridgewood Drive, Prestonsburg, KY 41653 | 2016-06-28 |
| 1356745509 | Rosanna Mccoy | Counselor | 105 Trimble Chapel Square, Prestonsburg, KY 41653 | 2014-10-17 |
| 1770828766 | Mary Whitney Amburgey | Physical Therapist | 5000 Ky-321, Prestonsburg, KY 41653 | 2012-12-03 |
| 1750648168 | Cynthia Crase | Social Worker | 311 N Arnold Ave Ste 504, Prestonsburg, KY 41653 | 2012-04-23 |
| 1003107566 | Shane Hensley | Pharmacist | 152 Collins Circle, Prestonsburg, KY 41653 | 2011-05-02 |
| 1659607018 | Paul Michael Burchett | Pharmacist | 5291 Ky Rte 321, Prestonsburg, KY 41653 | 2009-10-20 |
| Find all providers in zip 41653 | ||||
| Taxonomy Code | 207Q00000X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Family Medicine |
| Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. |
| Notes: Source: American Board of Family Medicine [1/1/2007: changed title; 7/1/2007: added definition, added source; 7/1/2017: modified definition] - Note: The American Osteopathic Board of Family Physicians certification includes extensive use of Osteopathic Manipulative Treatment (OMT), which integrates the biological, clinical, and behavioral sciences. - Additional Resources: American Board of Family Medicine, www.theabfm.org. American Osteopathic Board of Family Physicians, www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Family Medicine. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Family Physicians or the American Board of Family Medicine. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629424429 | Kevin Farthing | Family Medicine | 311 N Arnold Ave Ste 301, Prestonsburg, KY 41653-1279 | 2016-05-11 |
| 1609177021 | Commonwealth Quality Medical Management, LLC | Family Medicine | 387 Edgewood Ln, Prestonsburg, KY 41653-9196 | 2010-11-17 |
| 1043445927 | Mohammed Akhlack Hossain Mazumder | Family Medicine | 92 Pickett Ln, Prestonsburg, KY 41653-8569 | 2009-05-21 |
| 1225217821 | Alan J Hyden Md Psc | Family Medicine | 32 Grace Drive, Prestonsburg, KY 41653-8792 | 2007-10-31 |
| 1619195864 | David Wendell Martin | Family Medicine | 178 Douglas Parkway, Prestonsburg, KY 41501-6970 | 2007-04-23 |
| 1326103821 | All Family Healthcare | Family Medicine | 156 N Lake Dr, Prestonsburg, KY 41653-1270 | 2006-12-26 |
| 1184793986 | Hometown Family Care Pllc | Family Medicine | 400 University Drive, Suite 101a, Prestonsburg, KY 41653-1080 | 2006-11-07 |
| 1093742280 | Drema K Hunt | Family Medicine | 5230 Ky Route 321 Ste 8, Prestonsburg, KY 41653-9169 | 2006-06-26 |
| 1750371886 | Blake R Burchett | Family Medicine | 4851 Ky Route 321, Prestonsburg, KY 41653-9113 | 2005-10-28 |
| 1992367569 | Arh Tug Valley Health Services, Inc. | Family Medicine | 5000 Ky Route 321, Prestonsburg, KY 41653-9113 | 2019-07-03 |
| Find all providers in PRESTONSBURG | ||||
| City | PRESTONSBURG |
| Zip Code | 41653 |
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| 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.