NPIMap

Individual provider Active NPI

Neil B Thackar, DO

  • Diagnostic Radiology Physician
  • Winston Salem, NC
National Provider Identifier
1144845363
Registry record updated Sep 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Diagnostic Radiology PhysicianTaxonomy code 2085R0202X
License
2025-01950 Issued in NC
Practice address
Medical Center Blvd
Winston Salem, NC 27157-0001
Phone
(336) 716-7243
Fax
(336) 716-7432
NPI assigned
Jun 12, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 5, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X 11860 GA
Diagnostic Radiology Physician 2085R0202X 2025-01950 NC Primary

Addresses

Primary practice location

Medical Center Blvd
Winston Salem, NC 27157-0001

Mailing address

100 Kimel Forest Dr
Winston Salem, NC 27103-6074
Phone (336) 716-1331

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20251021003058 NC Practitioner - Diagnostic Radiology 1759704562 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Diagnostic Radiology
Education
Nova Southeastern College of Osteo Medicine, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Radiology Imaging Associates LLCGroup PAC ID 2466342803, 182 clinicians
Stern Drake Isbell and Associates PAGroup PAC ID 3779480835, 57 clinicians

Practice addresses (Care Compare)

151 Edgeway Dr
Apt 304
Winston Salem, NC 27104-4259
Phone (352) 351-7200

Medical Ctr Blvd
Winston Salem, NC 27157-0001
Phone (336) 716-2734

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
2025-01950NCMDDiagnostic Radiology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Aug 22, 2025 Accepting new patients
Wake Forest University Health Sciences CurrentSince Jul 21, 2025 Accepting new patients
Wake Forest Baptist Imaging, LLC Diagnostic Radiology CurrentSince Aug 22, 2025 Accepting new patients
Stern, Drake, Isbell & Associates, PA Diagnostic Radiology CurrentSince Oct 15, 2025 Accepting new patients
Radiology Imaging Associates, LLC Diagnostic Radiology CurrentSince Jan 1, 2026 Accepting new patients

Locations

577 N Williamson Blvd
Daytona Beach, FL 32114

4211 Van Dyke Rd
Lutz, FL 33558
Phone (813) 265-6300

1500 SW 1st Ave
Ocala, FL 34471
Phone (352) 351-7500

3202 N Park Rd
Plant City, FL 33563
Phone (813) 727-1200

6901 Simmons Loop
Riverview, FL 33578
Phone (813) 302-8000

3030 W Mlk Blvd
Tampa, FL 33607
Phone (813) 870-4000

3001 W Mlk Blvd
Tampa, FL 33607
Phone (813) 361-6778

861 Old Winston Rd
Ste 105
Kernersville, NC 27284
Phone (336) 765-5722

1370 W D St
North Wilkesboro, NC 28659
Phone (336) 651-8100

265 Executive Park Blvd
Winston Salem, NC 27103
Phone (336) 765-5722

100 Kimel Forest Dr
Winston Salem, NC 27103
Phone (336) 713-0947

Medical Ctr Blvd
Winston Salem, NC 27157
Phone (336) 713-2697

Interoperability endpoints

  • Direct secure messaging: nthackar3013220@carolinashealthcaresystem.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 9

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": "1591920000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1757030400000",
    "number": "1144845363",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 KIMEL FOREST DR",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271036074",
            "telephone_number": "336-716-1331"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "MEDICAL CENTER BLVD",
            "city": "WINSTON SALEM",
            "state": "NC",
            "postal_code": "271570001",
            "telephone_number": "336-716-7243",
            "fax_number": "336-716-7432"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKAR",
        "first_name": "NEIL",
        "middle_name": "B",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-06-12",
        "last_updated": "2025-09-05",
        "certification_date": "2025-09-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "GA",
            "license": "11860",
            "primary": false
        },
        {
            "code": "2085R0202X",
            "taxonomy_group": "",
            "desc": "Radiology, Diagnostic Radiology",
            "state": "NC",
            "license": "2025-01950",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Winston Salem, NC

Sources for this page

Verify at the official NPI Registry.