Tobe Thacker, D.C.

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1704 Issued in ID

Practice address

1605 S Park Dr
Broken Bow, OK 74728-5724

Phone

(580) 584-3385

Fax

(580) 584-5454

NPI assigned

Feb 11, 2016

Last updated

Dec 12, 2019By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OK

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• A Better You Healthcare Clinic PLLC

  • Nurse Practitioner
  • Broken Bow, OK
  • NPI 1235997594
  NPD Authorized official
• Tobe Thacker

  dba Broken Bow Chiropractic

  • Chiropractor
  • Broken Bow, OK
  • NPI 1871952481
  Authorized official Same address or phone
• Houk Chiropractic-Coeur D'Alene P.C.

  • Chiropractor
  • Coeur d'Alene, ID
  • NPI 1104264811
  NPD (past)

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576108800000",
    "number": "1215396874",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285724",
            "telephone_number": "580-584-3385",
            "fax_number": "580-584-5454"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285724",
            "telephone_number": "580-584-3385",
            "fax_number": "580-584-5454"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "TOBE",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2016-02-11",
        "last_updated": "2019-12-12",
        "certification_date": "2019-12-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "OK",
            "license": "4336",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nicole Smith
• Stover Family Clinic
• Rebecca Stover, RN, NP-C
• Pierre Francis Taron III, D.C.
• Texarkana Eye Associates-Broken Bow Branch
• Three Rivers Consulting & Management ,LLC (Complete Hospice Care of Eastern Oklahoma)
• TLC Family Clinic, LLC
• Tobe Thacker (Broken Bow Chiropractic)
• Sarah Todd
• Renisa Underwood

• Chiropractor in Broken Bow, OK
• Providers in Broken Bow, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2019; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.