NPIMap

Individual provider Active NPI

Hollie Marie Thacker

  • Certified Registered Nurse Anesthetist
  • Lincoln Park, MI
National Provider Identifier
1083232391
Registry record updated Feb 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
License
4704278682 Issued in MI
Practice address
1050 Ford Blvd
Lincoln Park, MI 48146-4225
Phone
(313) 400-0123
NPI assigned
Jul 13, 2020
Last updated
Feb 27, 2023By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X 4704278682 MI Primary
Registered Nurse 163W00000X 4704278682 MI

Addresses

Primary practice location

1050 Ford Blvd
Lincoln Park, MI 48146-4225

Mailing address

1050 Ford Blvd
Lincoln Park, MI 48146-4225
Phone (313) 400-0123

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MI

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20201221001514 MI Practitioner - Certified Registered Nurse Anesthetist (Crna) 1254743065 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Certified Registered Nurse Anesthetist (Crna)
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Scheurer HospitalGroup PAC ID 1456242296, shared by 10 NPIs, 49 clinicians

Practice addresses (Care Compare)

170 N Caseville Rd
Pigeion, MI 48755-9704
Phone (989) 453-3223

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Scheurer Hospital CurrentSince Jul 1, 2022 Accepting new patients
Scheurer Hospital Nurse Anesthetist, Certified Registered CurrentSince Jul 1, 2022 Accepting new patients
Scheurer Hospital CurrentSince Aug 1, 2025 Accepting new patients
Scheurer Hospital Current Accepting new patients
Northstar Anesthesia of Michigan PLLC Nurse Anesthetist, Certified Registered CurrentSince Oct 23, 2020 Accepting new patients

Locations

4201 Saint Antoine St
Detroit, MI 48201
Phone (313) 745-3615

170 N Caseville Rd
Pigeon, MI 48755
Phone (989) 453-3223

Organizations & group practices 5

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

Hospital & facility affiliations 11

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1594598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677456000000",
    "number": "1083232391",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 FORD BLVD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464225",
            "telephone_number": "313-400-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 FORD BLVD",
            "city": "LINCOLN PARK",
            "state": "MI",
            "postal_code": "481464225",
            "telephone_number": "313-400-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "HOLLIE",
        "middle_name": "MARIE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-13",
        "last_updated": "2023-02-27",
        "certification_date": "2023-02-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "MI",
            "license": "4704278682",
            "primary": true
        },
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MI",
            "license": "4704278682",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Lincoln Park, MI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.