Individual provider Active NPI

Taylor Thacker, FNP-C

  • Family Nurse Practitioner
  • Clinton, IA
National Provider Identifier
1114784865
Registry record updated Oct 1, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
A177749 Issued in IA
Practice address
2635 Lincoln Way Ste a
Clinton, IA 52732-7229
Phone
(563) 243-1413
NPI assigned
Feb 29, 2024
Last updated
Oct 1, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X A177749 IA Primary

Addresses

Primary practice location

2635 Lincoln Way Ste a
Clinton, IA 52732-7229

Mailing address

1120 Willany Dr
Clinton, IA 52732-3302
Phone (563) 451-5960

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IA
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240820004596 IA Practitioner - Nurse Practitioner 7911445002 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Womens Health Services of Eastern Iowa IncGroup PAC ID 0244120681, 4 clinicians
Sequoia Medical Services PLLCGroup PAC ID 3577918416, 2 clinicians

Practice addresses (Care Compare)

2635 Lincoln Way
Suite a
Clinton, IA 52732-7229
Phone (563) 243-1413

770 Tanglefoot LN
Suite 3256
Bettendorf, IA 52722-1608
Phone 56339621003256

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
SBH-Davenport, LLC CurrentSince Jun 13, 2024 Accepting new patients
Sequoia Medical Services PLLC CurrentSince Jul 7, 2024 Accepting new patients
Womens Health Services of Eastern Iowa Inc CurrentSince Mar 9, 2026 Accepting new patients
SBH-Davenport, LLC CurrentSince Jun 13, 2024 Accepting new patients

Locations

770 Tanglefoot Ln
Bettendorf, IA 52722
Phone (563) 241-7443

770 Tanglefoot Ln
#3256
Bettendorf, IA 52722
Phone (563) 396-2100

2635 Lincoln Way
Clinton, IA 52732
Phone (563) 243-1413

2635 Lincoln Way
Ste A
Clinton, IA 52732
Phone (563) 241-1328

229 S Main St
Maquoketa, IA 52060
Phone (563) 352-3749

Interoperability endpoints

  • FHIR API: https://fhir4.healow.com/fhir/r4/CFHCAA/Endpoint/CFHCAA

Organizations & group practices 4

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": "1709164800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1790812800000",
    "number": "1114784865",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1120 WILLANY DR",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527323302",
            "telephone_number": "563-451-5960"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2635 LINCOLN WAY STE A",
            "city": "CLINTON",
            "state": "IA",
            "postal_code": "527327229",
            "telephone_number": "563-243-1413"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "TAYLOR",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-02-29",
        "last_updated": "2026-10-01",
        "certification_date": "2026-10-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IA",
            "license": "A177749",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clinton, IA

Sources for this page

Verify at the official NPI Registry.