TAMMY L WHITEHEAD, ARNP
NPI 1326272493, individual, London, KY, Nurse Practitioner, Psych/Mental Health
- Hours beyond a day in 3 months, but with up to 693 patients a month, which points to a supervising clinician on the claims rather than one person's hours.
- Records needed.
Hours billed per day
Medicaid billing converted into hours of hands-on care per day. The lower bound counts one unit per claim line and needs no price; the other two divide dollars by a unit price, the conservative one at 1.5 times the price. The clinician on the claim may be a supervisor under state rules, so billing organizations are counted too.
| month | what was found | hours per day, lower bound | hours per day, at price | hours per day, conservative | per working day | patients | billing organizations | codes | paid |
|---|---|---|---|---|---|---|---|---|---|
| May 2023 | More hours than a day holds, even counting one unit per claim line | 36.8 | 68.6 | 45.7 | 17.9 | 613 | 1 | 90791 90832 90833 90837 90846 90847 99204 99213 H0038 H2015 | $105K |
| Aug 2023 | More hours than a day holds, even counting one unit per claim line | 50.9 | 112.2 | 74.8 | 17.3 | 693 | 1 | 90791 90832 90833 90837 90846 90847 99204 99213 H0038 H2015 | $154K |
| Feb 2024 | More hours than a day holds, even counting one unit per claim line | 55.6 | 146.2 | 97.5 | 18.1 | 460 | 1 | 90791 90832 90833 90837 90847 90853 99213 H0038 H2015 | $178K |
National provider registry
From the CMS NPPES Registry, refreshed daily.
| Name | TAMMY L WHITEHEAD, ARNP |
| Type | Individual |
| Status | Active |
| NPI issued | May 5, 2009, last updated December 30, 2024 |
| Practice location | 725 S MAIN ST, London, KY 40741-1903, 606-770-5161 |
| Mailing address | 43 WACO DR, London, KY 40741-8327 |
| Specialties | Nurse Practitioner (363L00000X, license 6097P KY) Nurse Practitioner, Psych/Mental Health (363LP0808X, primary, license 3006097 KY) |
Procedures billed
The specific codes behind the dollars. Medicaid figures come from T-MSIS (2018 to 2024) and are compared with every other provider billing the same code; Medicare figures come from the 2024 physician and supplier file and compare this provider's submitted charge with what Medicare allowed, against the usual ratio for that code.
| code | what it is | paid | share | per patient-month | typical | rank among providers | |
|---|---|---|---|---|---|---|---|
| H0038 | Self-help/peer services per 15 min | $2.7M | 42% | $1K | $147 (top 5% from $2K) | 94th percentile | |
| H0015 | Alcohol/drug intensive outpatient per diemhistory of abuse | $1.1M | 17% | $850 | $666 (top 5% from $2K) | 67th percentile | |
| T2023 | Medicaid service code | $724K | 11% | $342 | $332 (top 5% from $1K) | 60th percentile | |
| 90837 | Psychotherapy, 1 hourhistory of abuse | $550K | 9% | $170 | $191 (top 5% from $442) | 40th percentile | |
| H2020 | Therapeutic behavioral services per diem | $194K | 3% | $1K | $455 (top 5% from $2K) | 86th percentile | |
| H2027 | Psychoeducational service per 15 min | $185K | 3% | $1K | $161 (top 5% from $4K) | 82nd percentile | |
| H0031 | Medicaid service code | $147K | 2% | $63 | $100 (top 5% from $540) | 33rd percentile | |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | $122K | 2% | $38 | $49 (top 5% from $109) | 35th percentile |
| code | what it is | services | beneficiaries | paid | submitted per service | allowed per service | charge to allowed | usual for this code |
|---|---|---|---|---|---|---|---|---|
| 90837 | Psychotherapy, 1 hour | 119 | 11 | $11K | $186 | $123 | 1.5x | 1.6x (90th percentile 2.9x) |
| 90833 | Psychotherapy with evaluation and management visit, 30 minutes | 40 | 11 | $2K | $66 | $58 | 1.1x | 2.1x (90th percentile 3.5x) |
| 99213 | Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more | 32 | 11 | $2K | $109 | $71 | 1.5x | 2.2x (90th percentile 3.8x) |
| 90785 | Psychiatric services complicated by communication factor | 112 | 12 | $1K | $18 | $12 | 1.6x | 2.4x (90th percentile 7.3x) |
A submitted charge many times the allowed amount is common and lawful; it matters when it is far above what other providers submit for the same code.
In this area
3 providers in Laurel County, KY carry an indicator in the public record, with $729K at stake between them. The most common is more hours than a day holds, on 2 of them, followed by paid after a public list action on 1. 1 is tier 1: documented action, then payment.
| tier | provider | at stake | why |
|---|---|---|---|
| 1 | CAROLINE HENDY London, KY, ranked 417 | $473 |
|
| 4 | GEORGIA DUNN London, KY, ranked 9483 | $186K |
|
| 5 | GRETA ALEXANDER London, KY, ranked 11193 | $542K |
Recent enforcement in KY
All releasesDepartment of Justice and HHS-OIG releases for this state, newest first. Each opens in a new tab.
Referral packet
The packet is a draft for a reviewer. It reads every public record behind this case, states what the records show with a citation for each finding, names the regulation each finding relates to, and lists the ordinary explanations to rule out first. It never asserts intent.