KENNETH LEE TACKETT (RN, CNP) – Psychiatric/Mental Health Nurse Practitioner, NPI 1063099554
Psychiatric/Mental Health Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
22,204 NURSE PRACTITIONER in TX
Provider Addresses for KENNETH LEE TACKETT (RN, CNP)
4300 DUNLAVY ST APT 5118
HOUSTON, TX 770065441
Phone: (601) 927-7224
Mailing address matches the actual address.
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
CMS reports 110 Open Payments records for all available years, with a total value of $2,141.
Total Amount is formed as General ($2,141) + Research ($0) + Ownership ($0) = $2,141.
Last reported payment date: 2024-12-17 • Largest payer in this snapshot: Otsuka America Pharmaceutical, Inc. ($489).
Total Amount
$2,141
General + Research + Ownership
Payments
110
Total payment records
General Amount
$2,141
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-12-17
Latest reported date
Top Companies
Largest payers in this snapshot
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2022-09-05
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Due date not assigned yet
CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.
Enrollment records
1
Earliest due date
Not assigned (TBD)
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20220905000268 | I | Nurse Practitioner | TX | TBD |
What to do next
- No action required while the due date shows TBD.
- Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
- Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 77006)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| P S Y C H I A T R Y | TX | |
| Nurse Practitioner | TX | |
| - | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | CA | |
| Clinical Psychologist | CA | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Nurse Practitioner | TX | |
| Physician Assistant | TX |
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