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

David Thomas Tackett, APRN

Individual provider Nurse Practitioner · NPI 1043821085

David Thomas Tackett, APRN is a Nurse Practitioner in Edgewood, Kentucky. Graduated from University of Cincinnati College of Medicine in 2020, 6 years ago. Practices with Summit Medical Group Inc, a 799-clinician group and accepts Medicare assignment. Licensed in Kentucky.

Years since qualifying
6
Trained at
University of Cincinnati College of Medicine
Licensed in
KY
In the registry since
2020
What do these letters mean?
APRN — Advanced Practice Registered Nurse
The umbrella licence covering nurse practitioners, midwives, anaesthetists and clinical nurse specialists.

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Practice location Address checks out

20 Medical Village Dr
Edgewood, KY 41017-5401
Phone: (859) 578-5880
Fax: (859) 578-5881
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Nurse Practitioner (primary) Taxonomy 363L00000X · Licence 1136773 (KY)

Record details

NPI number1043821085
Entity typeIndividual (Type 1)
GenderMale
Credentials APRN
Sole proprietorYes
NPI enumeratedAugust 13, 2020
Last updated in NPPESAugust 13, 2020
Certification dateAugust 13, 2020
Mailing addressPo Box 635283, Cincinnati, OH 45263-5283

Medicare enrollment

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

Medicare specialtyNURSE PRACTITIONER
Medical schoolUNIVERSITY OF CINCINNATI COLLEGE OF MEDICINE
Graduated 2020 (6 years in practice)
Group practice Summit Medical Group Inc — 799 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

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