Individual provider Active NPI

Anne Leslie Thatcher, DNP, APRN, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Park Ridge, IL
National Provider Identifier
1245708239
Registry record updated Mar 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X
License
209019207 Issued in IL
Practice address
1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471
Phone
(847) 759-9110
NPI assigned
Nov 7, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 1, 2023

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 2018039619 MO
Psychiatric/Mental Health Nurse Practitioner 363LP0808X 209019207 IL Primary
Psychiatric/Mental Health Nurse Practitioner 363LP0808X G153333 IA
Psychiatric/Mental Health Nurse Practitioner 363LP0808X APRN-197685 MT

Addresses

Primary practice location

1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471

Mailing address

1440 Renaissance Dr Ste 320
Park Ridge, IL 60068-1471
Phone (847) 759-9110

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address annethatcher@thejunipercenter.com Direct

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IL
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
I20230523000554 IL Practitioner - Nurse Practitioner 5294191961 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Washington University School of Medicine, 2008
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
The Juniper Center PCGroup PAC ID 1557557725, 26 clinicians

Practice addresses (Care Compare)

1440 Renaissance Dr
Suite 320
Park Ridge, IL 60068-1471
Phone (847) 778-4533

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
G153333IAMDPsychiatric/Mental Health Nurse Practitioner
209019207ILMDPsychiatric/Mental Health Nurse Practitioner
2018039619MOMDPsychiatric/Mental Health Nurse Practitioner
APRN-197685MTMDPsychiatric/Mental Health Nurse Practitioner

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1541548800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1677628800000",
    "number": "1245708239",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 320",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681471",
            "telephone_number": "847-759-9110"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1440 RENAISSANCE DR STE 320",
            "city": "PARK RIDGE",
            "state": "IL",
            "postal_code": "600681471",
            "telephone_number": "847-759-9110"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THATCHER",
        "first_name": "ANNE",
        "middle_name": "LESLIE",
        "name_prefix": "Dr.",
        "credential": "DNP, APRN, PMHNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-07",
        "last_updated": "2023-03-01",
        "certification_date": "2023-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MO",
            "license": "2018039619",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IL",
            "license": "209019207",
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "IA",
            "license": "G153333",
            "primary": false
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "MT",
            "license": "APRN-197685",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "annethatcher@thejunipercenter.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "email",
            "address_1": "1440 Renaissance Dr Ste 320",
            "city": "Park Ridge",
            "state": "IL",
            "country_code": "US",
            "postal_code": "600681471",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Park Ridge, IL

Sources for this page

Verify at the official NPI Registry.