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

Dr. Edward O Tackey, MD

Individual provider Specialist · NPI 1669488110

Dr. Edward O Tackey, MD is a Rheumatology in Salem, Virginia. Qualified in 1990, 36 years ago. Practices with Kennedy Medical Group Practice, PC, a 414-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Delaware, Oregon and Virginia.

Years since qualifying
36
Licensed in
DE, OR, VA
In the registry since
2006
Specialties on file
3
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

1930 Braeburn Cir
Salem, VA 24153-7388
Phone: (540) 772-3707
Fax: (540) 772-3739
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Rheumatology Physician (primary) Taxonomy 207RR0500X · Licence C1-0023857 (DE)
Specialist Taxonomy 174400000X · Licence MD24622 (OR)
Rheumatology Physician Taxonomy 207RR0500X · Licence 0101243144 (VA)

Record details

NPI number1669488110
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedAugust 1, 2006
Last updated in NPPESAugust 26, 2020
Certification dateAugust 26, 2020
Mailing address260 Beiser Blvd, Ste 201, Dover, DE 19904-5773

Medicare enrollment

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

Medicare specialtyRHEUMATOLOGY
Medical schoolOTHER
Graduated 1990 (36 years in practice)
Group practice Kennedy Medical Group Practice, P.C. — 414 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services

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