CARSON STONE TACKETT
NPI 1679355234
Anesthesiologist Assistant in Greenwood Village, CO

Q: What is Carson Tackett's NPI number?

The NPI number for Carson Tackett is 1679355234. It was assigned to this individual provider in the NPPES registry on October 18, 2023.

Q: What is Carson Tackett's specialty?

The primary specialty registered for this NPI is Anesthesiologist Assistant with taxonomy code 367H00000X.

Q: When was this NPI record last updated?

The NPPES record for Carson Tackett was last updated on June 5, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since October 18, 2023Accepts Medicare Assignment

8000 E MAPLEWOOD AVE STE 120, GREENWOOD VILLAGE, CO 80111(303) 438-3999(720) 439-9500 Get Directions Write a Review

NPPES record last updated: June 5, 2024. Verified against the NPPES registry weekly; last sync: August 02, 2026.

Record update history: Jun 5, 2024, Oct 18, 2023 (2 updates tracked since 2023).

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About Carson Stone Tackett NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARSON STONE TACKETT (NPI 1679355234) is an individual anesthesiologist assistant in Greenwood Village, Colorado, licensed in Colorado (ANT.0000250) and active in the NPI registry since October 2023. He maintains a secondary practice location in Ft Lauderdale and is a graduate of Other (2024).

NPPES Registry Identity

NPI1679355234

Entity TypeIndividualMale

Primary Taxonomy367H00000X

Provider Legal NameCARSON STONE TACKETT

Location Address8000 E MAPLEWOOD AVE STE 120Greenwood Village, CO 80111-4766

Mailing AddressPo Box 840862Dallas, TX 75284-0862 · (303) 377-7638 · Fax (303) 780-0787

Phone(303) 438-3999

Fax(720) 439-9500

Sole ProprietorNo

Medical School CMSOtherGraduated 2024

Enumeration DateOctober 18, 2023

Last NPPES UpdateJune 5, 20242 updates tracked since enumeration

NPPES CertifiedJune 5, 2024

✔ NPI 1679355234 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyAnesthesiologist AssistantPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code367H00000X

License✔ Licensed in CO · ANT.0000250

Definition

An individual certified by the state to perform anesthesia services under the direct supervision of an anesthesiologist. Anesthesiologist Assistants are required to have a bachelor's degree with a premed curriculum prior to entering a two-year anesthesiology assistant program, which is focused upon the delivery and maintenance of anesthesia care as well as advanced patient monitoring techniques. An Anesthesiologist Assistant must work as a member of the anesthesia care team under the direction of a qualified Anesthesiologist.

8000 E MAPLEWOOD AVE STE 120, Greenwood Village, CO 80111

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Secondary Practice Location 1

Location 13300 S University DrFt Lauderdale, FL 33328-2004 · Phone (800) 541-6682

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Carson Stone Tackett is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID8628511482

PECOS Enrollment IDI20240620003628

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

JENNIFER K KROGH CRNA

Nurse Anesthetist, Certified Registered