Individual provider Active NPI

Trishna Chand Thakur, MBBS

  • Psychiatry Physician
  • Jacksonville, NC
National Provider Identifier
1093367856
Registry record updated May 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatry PhysicianTaxonomy code 2084P0800X
License
321065 Issued in NC
Practice address
200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone
(910) 938-1114
Fax
(910) 938-1118
NPI assigned
Jul 11, 2019
Last updated
May 22, 2024By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 22, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Student in an Organized Health Care Education/Training Program 390200000X
Student in an Organized Health Care Education/Training Program 390200000X 0116038103 VA
Student in an Organized Health Care Education/Training Program 390200000X VA
Psychiatry Physician 2084P0800X 321065 NC Primary

Addresses

Primary practice location

200 Tarpon TRL
Jacksonville, NC 28546-5287

Mailing address

200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone (910) 938-1114

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240701002003 NC Practitioner - Psychiatry 4486982535 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Psychiatry
Education
Other, 2024
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Coastal Carolina Neuropsychiatric Center PAGroup PAC ID 5890794689, 28 clinicians

Practice addresses (Care Compare)

200 Tarpon TRL
Jacksonville, NC 28546-5287
Phone (910) 938-1114

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
321065NCMDPsychiatry Physician
0116038103VAMDStudent in an Organized Health Care Education/Training Program

Practice roles

OrganizationSpecialtyStatusNew patients
Coastal Carolina Neuropsychiatric Center, PA Psychiatry CurrentSince Jun 4, 2024 Accepting new patients

Locations

1200 Fairmont Ct
Fayetteville, NC 28304
Phone (910) 429-1114

200 Tarpon Trl
Jacksonville, NC 28546
Phone 9109381114139

302 Penny Ln
Morehead City, NC 28557
Phone (252) 726-8016

1630 Military Cutoff Rd
Ste 108
Wilmington, NC 28403

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1562803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716336000000",
    "number": "1093367856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 TARPON TRL",
            "city": "JACKSONVILLE",
            "state": "NC",
            "postal_code": "285465287",
            "telephone_number": "910-938-1114",
            "fax_number": "910-938-1118"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAKUR",
        "first_name": "TRISHNA CHAND",
        "credential": "MBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-11",
        "last_updated": "2024-05-22",
        "certification_date": "2024-05-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": "0116038103",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "VA",
            "license": null,
            "primary": false
        },
        {
            "code": "2084P0800X",
            "taxonomy_group": "",
            "desc": "Psychiatry & Neurology, Psychiatry",
            "state": "NC",
            "license": "321065",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jacksonville, NC

Sources for this page

Verify at the official NPI Registry.