Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Benjamin Tackett, FNP

Individual provider Family Nurse Practitioner · NPI 1265959704

Benjamin Tackett, FNP is a Nurse Practitioner in Logan, West Virginia. Qualified in 2017, 9 years ago. Practices with Charleston Area Medical Center Inc, a 968-clinician group and accepts Medicare assignment. Licensed in West Virginia.

Years since qualifying
9
Licensed in
WV
In the registry since
2017
What do these letters mean?
FNP — Family Nurse Practitioner
A nurse practitioner who treats patients of all ages, much like a family doctor.

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Practice location Address checks out

140 Stollings Ave Ste 1
Logan, WV 25601-4035
Phone: (304) 752-2555
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 66717 (WV)

Record details

NPI number1265959704
Entity typeIndividual (Type 1)
GenderMale
Credentials FNP
Sole proprietorNo
NPI enumeratedAugust 25, 2017
Last updated in NPPESAugust 25, 2017
Mailing address140 Stollings Ave Ste 1, Logan, WV 25601-4035

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2017 (9 years in practice)
Group practice Charleston Area Medical Center Inc — 968 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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