Individual provider Active NPI

Michael Thatcher, PHARMD

  • Pharmacist
  • Fort Worth, TX
National Provider Identifier
1063012888
Registry record updated Oct 30, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
61506 Issued in TX
Practice address
3921 Benbrook Hwy
Fort Worth, TX 76116-7802
Phone
(817) 735-2135
NPI assigned
Oct 30, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2020

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X 61506 TX Primary

Addresses

Primary practice location

3921 Benbrook Hwy
Fort Worth, TX 76116-7802

Mailing address

3921 Benbrook Hwy
Fort Worth, TX 76116-7802

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
61506TXMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Perrone Pharmacy, Inc PastSince Nov 1, 2020 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1604016000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1604016000000",
    "number": "1063012888",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3921 BENBROOK HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3921 BENBROOK HWY",
            "city": "FORT WORTH",
            "state": "TX",
            "postal_code": "761167802",
            "telephone_number": "817-735-2135"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATCHER",
        "first_name": "MICHAEL",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-10-30",
        "last_updated": "2020-10-30",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "TX",
            "license": "61506",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Fort Worth, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 30, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.