CARLYN E TACKETT APRN
NPI 1720610587
Nurse Practitioner - Family in Sapulpa, OK
About Carlyn E Tackett Aprn NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
CARLYN E TACKETT APRN (NPI 1720610587) is an individual family provider in Sapulpa, Oklahoma, licensed in Oklahoma (113970) and active in the NPI registry since February 2020. She is enrolled in Medicare PECOS.
NPPES Registry Identity
Specialties & Licenses 2
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Carlyn E Tackett Aprn is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Medicare Billing Reassignments
2Medicare enrollment records show Carlyn Tackett reassigns Medicare billing to 2 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.
Sapulpa, OK 74066
- Reassigned Medicare billing, Oklahoma enrollment
- 2 clinicians in this Medicare group
Tulsa, OK 74133
- Reassigned Medicare billing, Oklahoma enrollment
- 8 clinicians in this Medicare group
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Physician Visit Costs CMS claims · ZIP area
Typical Medicare office-visit costs in the 74066 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.
Other Providers at the Same Location NPPES 2
Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.
Frequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Carlyn Tackett's NPI number?
The NPI number for Carlyn Tackett is 1720610587. It was assigned to this individual provider in the NPPES registry on February 10, 2020.
Where is Carlyn Tackett located?
Carlyn Tackett practices at 16 S Water St, Sapulpa, OK 74066. The listed phone number is (918) 347-9022.
What is Carlyn Tackett's specialty?
The primary specialty registered for this NPI is Nurse Practitioner, specializing in Family, with taxonomy code 363LF0000X.
Is Carlyn Tackett enrolled in Medicare?
Yes. Carlyn Tackett is registered in the Medicare PECOS enrollment system.
Which organizations bill Medicare for Carlyn Tackett's services?
According to the CMS Revalidation Reassignment List (October 2026 release), Carlyn Tackett reassigns Medicare benefits to 2 organizations: Divine Health And Wellness, LLC (Sapulpa, OK) and Apex Wound Management LLC (Tulsa, OK). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Carlyn Tackett's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.
What insurance does Carlyn Tackett accept?
Health plans from Blue Cross and Blue Shield of Oklahoma list Carlyn Tackett as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Carlyn Tackett was last updated on April 16, 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.
# Carlyn E Tackett, APRN · NPI 1720610587
Family physician in Sapulpa, Oklahoma. Individual provider, active in the CMS NPPES registry since February 10, 2020.
## Identity
- **NPI:** 1720610587 (Entity type: Individual)
- **Enumerated:** February 10, 2020
- **Primary specialty:** Nurse Practitioner - Family · taxonomy 363LF0000X
- **State license:** 113970 (Oklahoma)
- **Sole proprietor:** No
## Practice location
- **Address:** 16 S WATER ST, Sapulpa, OK 74066-4232
- **Phone:** (918) 347-9022
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Ordering & referring:** eligible for Part B labs & imaging, durable medical equipment, home health, power mobility devices
- **Bills Medicare through:** 2 organizations under Medicare reassignment (form CMS-855R): Divine Health And Wellness, LLC (NPI 1790528164, Sapulpa, OK); Apex Wound Management LLC (NPI 1740067727, Tulsa, OK) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** April 16, 2024
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Source: [NPI Profile](https://npiprofile.com/npi/1720610587) · Data from the CMS NPPES public registry.