MR. JIM R TACKETT (PA-C) – Physician Assistant, NPI 1104882083

MR. JIM R TACKETT (PA-C) is a healthcare provider. based in Lexington, Kentucky. specializing in Physician Assistant. They hold the professional credentials PA-C. They hold a License No. PA553 (KY). The NPI Number for MR. JIM R TACKETT (PA-C) is 1104882083

Main info

Male
Name
MR. JIM R TACKETT (PA-C)
NPI
1104882083
Phone
(859) 233-4511
Address
1101 VETERANS DR
Enumeration Date
21 April 2006
Last Update Date
24 February 2011
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience54
Completeness75
Years active:20State licenses:1Digital endpointsOther names

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Provider Addresses for MR. JIM R TACKETT (PA-C)

  • Lexington VA Medical Center, 1101, Veterans Drive, North Elizabeth Street, Lexington, Fayette County, Kentucky, 40536, United States

    LEXINGTON, KY 405022235

    Phone: (859) 233-4511

    Type: Location

  • 2150 ELMFORK RD

    NICHOLASVILLE, KY 403569619

    Phone: (859) 887-9163

    Type: Mailing

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 7 Open Payments records for all available years, with a total value of $943.

Total Amount is formed as General ($943) + Research ($0) + Ownership ($0) = $943.

Last reported payment date: 2024-10-30 • Largest payer in this snapshot: Boston Scientific Corporation ($806).

Total Amount

$943

General + Research + Ownership

Payments

7

Total payment records

General Amount

$943

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-10-30

Latest reported date

Top Companies

Largest payers in this snapshot

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Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

No Medicare enrollment or revalidation data available for this provider in our database.

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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 40502)

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Reviews

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Frequently asked questions

What federal number belongs to MR. JIM R TACKETT (PA-C)?
The federal identifier for MR. JIM R TACKETT (PA-C) is NPI 1104882083.
Is MR. JIM R TACKETT (PA-C)'s NPI currently valid?
The extract we use shows MR. JIM R TACKETT (PA-C) as active.
Can you summarize MR. JIM R TACKETT (PA-C)'s specialty in plain language?
Clinically, the directory lists MR. JIM R TACKETT (PA-C) with Physician Assistant. Clinical services aligned with this taxonomy classification.
Where is MR. JIM R TACKETT (PA-C)'s primary listing?
We display Lexington, Kentucky because that is what the record indicates for MR. JIM R TACKETT (PA-C).
Is MR. JIM R TACKETT (PA-C) a real provider?
This page reflects official NPPES data for NPI 1104882083. Always confirm identity and privileges with the practice and licensing boards.

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