DR. REVA DUFF TACKETT (NPI# 1215916044) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215916044 |
| Entity Type | Individual |
| Full Name | DR. REVA DUFF TACKETT |
| Credential | MD |
| Practice Address |
1720 Nicholasville Rd Ste 403 Lexington KY 40503 |
| Practice Telephone | 8592780363 |
| Practice Fax Number | 8592776938 |
| Mailing Telephone | 8592780363 |
| Mailing Fax Number | 8592776938 |
| Enumeration Date | 2006-01-11 |
| Last Update Date | 2013-07-18 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 207VG0400X |
Obstetrics & Gynecology Specialization: Gynecology |
20064 | KY | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| KY | 64220643 | 05 |
| Street Address |
1720 NICHOLASVILLE RD STE 403 |
| City | LEXINGTON |
| State | KY |
| Zip Code | 40503 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1639179484 | John J Gohmann | Internal Medicine | 1720 Nicholasville Rd, Suite 701, Lexington, KY 40503-1404 | 2005-07-22 |
| 1275167876 | Stephen P Schmelzer | Nurse Anesthetist, Certified Registered | 1720 Nicholasville Rd, Lexington, KY 40503-1404 | 2020-02-24 |
| 1104334184 | Shasta Cecil | Nurse Practitioner | 1720 Nicholasville Rd, Lexington, KY 40503-1404 | 2018-01-12 |
| 1194265827 | Matthew Kuhl | Nurse Practitioner | 1720 Nicholasville Rd, Suite 500, Lexington, KY 40503-1404 | 2017-02-28 |
| 1477002335 | Kassie Popp | Nurse Practitioner | 1720 Nicholasville Rd, Suite 601, Lexington, KY 40503-1404 | 2016-10-03 |
| 1932656956 | Lori Hazelwood | Physician Assistant | 1720 Nicholasville Rd, Suite 502, Lexington, KY 40503-1404 | 2016-09-07 |
| 1932552197 | Sabrina Tucker | Nurse Practitioner | 1720 Nicholasville Rd, Suite 702, Lexington, KY 40503-1404 | 2016-07-22 |
| 1568818946 | Cristina Elena Mcgrannahan | Physician Assistant | 1720 Nicholasville Rd, Suite 601, Lexington, KY 40503-1404 | 2016-05-04 |
| 1871948976 | Kristy Salley | Nurse Practitioner | 1720 Nicholasville Rd, 601, Lexington, KY 40503-1404 | 2016-04-27 |
| 1609270388 | Nicole Clevinger | Nurse Practitioner | 1720 Nicholasville Rd, Suite 601, Lexington, KY 40503-1404 | 2014-10-09 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548804743 | Lucas Kyle Brothers | Occupational Therapist | 401 Lewis Hargett Cir #120, Lexington, KY 40503 | 2019-10-30 |
| 1598322364 | Bobbi Jo Macqueston | Developmental Therapist | 825 Apache Trail, Lexington, KY 40503 | 2019-05-28 |
| 1750846234 | Smart Dental & Hygiene Express | Dentist | 2600 Nicholasville Rd Suite 120, Lexington, KY 40503 | 2019-02-08 |
| 1780148353 | Southland Child, Adult, and Family Counseling | Counselor | 2039 Regency Rd., Ste 1, Lexington, KY 40503 | 2019-01-28 |
| 1073093357 | Amanda Zachem | Nurse Practitioner | 1780 Nicholasville Rd., Suite #203, Lexington, KY 40503 | 2018-08-16 |
| 1083101240 | Man O War Urgent Care LLC | Nurse Practitioner | 4097 Nichols Park Dr Ste 108, Lexington, KY 40503 | 2018-04-13 |
| 1255833737 | Bennett Gatto | Physical Therapist | 3882 Mall Road, Lexington, KY 40503 | 2018-03-01 |
| 1528566114 | Alteri, LLC | Counselor | 1517 Nicholasville Rd Ste 402, Lexington, KY 40503 | 2018-01-29 |
| 1245748235 | Sherry Kay Adkins | Registered Nurse | Baptist Health Lexington 1740 Nicholasville Road, Diabetes Education, Lexington, KY 40503 | 2018-01-12 |
| 1003334780 | Martin Bennett Hundley | Counselor | 274 Southland Dr # 204, Lexington, KY 40503 | 2017-09-01 |
| Find all providers in zip 40503 | ||||
| Taxonomy Code | 207VG0400X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Obstetrics & Gynecology |
| Specialization | Gynecology |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215598230 | Elite Gynecology | Obstetrics & Gynecology | 163 Lake Murray Ter, Lexington, SC 29072-9103 | 2019-06-21 |
| 1003974171 | Lake Murray Obgyn | Obstetrics & Gynecology | 1404 W Main St Ste 1, Lexington, SC 29072-2332 | 2006-12-04 |
| 1679708432 | Lexmedical, Inc. | Obstetrics & Gynecology | 106 W Medical Park Dr, B, Lexington, NC 27292-6853 | 2009-05-22 |
| 1922207356 | Alisa C Gambrell | Obstetrics & Gynecology | University of Kentucky, 800 Rose Street, C-358, Lexington, KY 40536-0293 | 2007-07-16 |
| 1356448211 | James Christopher Stein | Obstetrics & Gynecology | University of Kentucky, 800 Rose Street, Lexington, KY 40506-0001 | 2006-09-20 |
| 1801819602 | Robert Bernard Thompson | Obstetrics & Gynecology | 160 N Eagle Creek Dr, Suite 400, Lexington, KY 40509-2121 | 2006-07-25 |
| 1407872559 | Waller Lisle Dalton | Obstetrics & Gynecology | 800 Rose Street, Lexington, KY 40536-0001 | 2006-07-14 |
| 1952345415 | Kathryn Dillon | Obstetrics & Gynecology | 800 Rose Street, Lexington, KY 40536-0001 | 2006-06-15 |
| 1801830328 | Paul Duane Depriest | Obstetrics & Gynecology | 800 Rose Street, Lexington, KY 40536-0001 | 2006-06-15 |
| 1538103056 | Christopher Phillip Desimone | Obstetrics & Gynecology | 800 Rose Street, Lexington, KY 40536-0001 | 2006-06-15 |
| Find all providers in LEXINGTON | ||||
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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.