Chelsea M Thacker, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

5992 Issued in TN

Practice address

2702 Jacksboro Pike
Jacksboro, TN 37757-4850

Phone

(423) 201-9937

NPI assigned

May 20, 2024

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

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

Specialty

Physician Assistant

Education

Lincoln Mem Univ, Debusk Col of Osteopathic Med, 2023

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Velocity Medical LLC 7 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

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.

• Velocity Medical LLC

  • Psychiatric/Mental Health Nurse Practitioner
  • New Castle, KY
  • NPI 1013352269

  TN

  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1716163200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1730332800000",
    "number": "1124867130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2702 JACKSBORO PIKE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377574850"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2702 JACKSBORO PIKE",
            "city": "JACKSBORO",
            "state": "TN",
            "postal_code": "377574850",
            "telephone_number": "423-201-9937"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "CHELSEA",
        "middle_name": "M",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2024-05-20",
        "last_updated": "2024-10-31",
        "certification_date": "2024-10-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "TN",
            "license": "5992",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Rissa Pryse Tamer, D.PH.
• Melinda Jane Teague
• Casey Terry
• Terry'S Pharmacy, Inc.
• Terrys Pharmacy Inc
• Amanda Ashley Thomas, APRN
• Norma B Tidwell, NA
• Timothy M Hall DMD PC
• Valley Medical
• Wal-Mart Stores East LP

• All providers in Jacksboro, TN
• Physician Assistant in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 31, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.