Individual provider Active NPI

Glynnis L Thatch, NP-C

  • Family Nurse Practitioner
  • Fishers, IN
National Provider Identifier
1366466492
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
71002292A Issued in IN
Practice address
13121 Olio Rd Ste 300
Fishers, IN 46037
Phone
(317) 621-1300
Fax
(317) 621-1310
NPI assigned
Jul 26, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 71002292A IN Primary

Addresses

Primary practice location

13121 Olio Rd Ste 300
Fishers, IN 46037

Mailing address

6626 E 75TH St Ste 500
Indianapolis, IN 46250-2890
Phone (317) 621-7547

Other practice location 1

11725 N Illinois St
Ste 325
Carmel, IN 46032-3002
Phone (317) 688-5800

Other practice location 2

11725 N Illinois St
Ste 325
Carmel, IN 46032-3002
Phone (317) 688-5800

Other identifiers 2

IdentifierTypeStateIssuer
251K00000XOtherINPUBLIC HEALTH
200904280MedicaidIN

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address gthatch126833@eCommunityDirect.com Community Physicians of Indiana Inc

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in IN
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
I20080729000754 IN Practitioner - Nurse Practitioner 7214001932 Reassigns benefits to 3 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Community Physicians of Indiana IncGroup PAC ID 1759416662, 1,569 clinicians

Practice addresses (Care Compare)

13121 Olio Rd
Suite 300
Fishers, IN 46037-7240
Phone (317) 621-1300

Hospital & facility affiliations

  • Community Hospital North Hospital, Indianapolis, IN, CCN 150169
  • Community Hospital East Hospital, Indianapolis, IN, CCN 150074

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
71002292AINMDFamily Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
University Family Physicians, Inc. CurrentSince Jan 1, 2019 Accepting new patients
University Family Physicians, Inc. CurrentSince Jan 1, 2019 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 16, 2019 Accepting new patients
Indiana University Health Care Associates, Inc Family CurrentSince Jan 26, 2015 Accepting new patients
Community Physicians of Indiana Inc CurrentSince Dec 16, 2019 Accepting new patients
University Medical Diagnostic Associates, Inc. Past Accepting new patients

Locations

5208 Reliable Pkwy
Chicago, IL 60686

5819 Reliable Pkwy
Chicago, IL 60686

7216 Solutions Ctr
Chicago, IL 60677

1115 Ronald Reagan Pkwy
Ste 364
Avon, IN 46123
Phone (317) 217-2636

11725 Illinois St
Ste 325
Carmel, IN 46032
Phone (317) 688-5800

13121 Olio Rd
Ste 300
Fishers, IN 46037
Phone (317) 621-1300

1701 N Senate Blvd
Bldg C6
Indianapolis, IN 46202
Phone (913) 962-2000

550 University Blvd
#3005
Indianapolis, IN 46202
Phone (317) 944-2167

250 N Shadeland Ave
Ste 130
Indianapolis, IN 46219
Phone (317) 962-4836

1520 N Senate Ave
Indianapolis, IN 46202
Phone (317) 962-0857

6626 E 75th St
Ste 500
Indianapolis, IN 46250
Phone (317) 621-7547

7120 Clearvista Dr
Ste 4000
Indianapolis, IN 46256
Phone (317) 621-7444

3545 W 86th St
Indianapolis, IN 46268
Phone (317) 228-0419

Interoperability endpoints

  • Direct secure messaging: gthatch126833@ecommunitydirect.com

Organizations & group practices 6

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 2

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": "1153872000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1366466492",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6626 E 75TH ST STE 500",
            "city": "INDIANAPOLIS",
            "state": "IN",
            "postal_code": "462502890",
            "telephone_number": "317-621-7547"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13121 OLIO RD STE 300",
            "city": "FISHERS",
            "state": "IN",
            "postal_code": "46037",
            "telephone_number": "317-621-1300",
            "fax_number": "317-621-1310"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "11725 N Illinois St",
            "address_2": "Ste 325",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460323002",
            "country_code": "US",
            "telephone_number": "317-688-5800",
            "fax_number": "317-688-5805",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11725 N Illinois St",
            "address_2": "Ste 325",
            "address_purpose": "LOCATION",
            "city": "Carmel",
            "state": "IN",
            "postal_code": "460323002",
            "country_code": "US",
            "telephone_number": "317-688-5800",
            "fax_number": "317-688-5805",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THATCH",
        "first_name": "GLYNNIS",
        "middle_name": "L",
        "name_prefix": "Mrs.",
        "credential": "NP-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-26",
        "last_updated": "2023-11-27",
        "certification_date": "2020-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "IN",
            "license": "71002292A",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PUBLIC HEALTH",
            "identifier": "251K00000X",
            "state": "IN"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "200904280",
            "state": "IN"
        }
    ],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "gthatch126833@eCommunityDirect.com",
            "affiliation": "Y",
            "affiliationName": "Community Physicians of Indiana Inc",
            "address_1": "13121 Olio Rd Ste 300",
            "city": "Fishers",
            "state": "IN",
            "country_code": "US",
            "postal_code": "46037",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Fishers, IN

Sources for this page

Verify at the official NPI Registry.