Rony Thannimoottilchirayil Chacko, AGACNP-BC

Primary specialty

Acute Care Nurse PractitionerTaxonomy code 363LA2100X

License

1141167 Issued in TX

Practice address

1001 Raintree Cir
Allen, TX 75013-4912

Phone

(972) 908-2000

NPI assigned

Jan 8, 2024

Last updated

Jan 8, 2024By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 3

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

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.

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

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

{
    "created_epoch": "1704672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1704672000000",
    "number": "1215707567",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4025 BASHFUL DR",
            "city": "PLANO",
            "state": "TX",
            "postal_code": "750936977",
            "telephone_number": "469-866-2643"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1001 RAINTREE CIR",
            "city": "ALLEN",
            "state": "TX",
            "postal_code": "750134912",
            "telephone_number": "972-908-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANNIMOOTTILCHIRAYIL CHACKO",
        "first_name": "RONY",
        "credential": "AGACNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-01-08",
        "last_updated": "2024-01-08",
        "certification_date": "2024-01-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1141167",
            "primary": true
        },
        {
            "code": "363LA2200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Adult Health",
            "state": "TX",
            "license": "1141167",
            "primary": false
        },
        {
            "code": "363LG0600X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Gerontology",
            "state": "TX",
            "license": "1141167",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Texas Spine and Wellness, LLC
• Texas Star Assisted Living LLC (Texas Star Assisted Living and Memory Care)
• Alexandra Marie Thakkar, LCSW
• Annie Thampan
• Smitha Susan Thankachan, PA-C
• The Art of Orthodontics
• The Bloom Center for Motherhood
• The Blueprint Physical Therapy
• The Children's Dentist of Allen
• The Dentist of Allen

• Acute Care Nurse Practitioner in Allen, TX
• Providers in Allen, TX by specialty
• Acute Care Nurse Practitioner in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.