Julie Ann Thacker, MS OTR/L

Primary specialty

Occupational TherapistTaxonomy code 225X00000X

License

3944 Issued in AZ

Practice address

1196 E Altadonna St
Queen Creek, AZ 85240-7846

Phone

(480) 274-3951

NPI assigned

Aug 26, 2008

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Master of Science

State licenses

Practice roles

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.

• Dynamite Therapy, LLC

  • Home Health Agency
  • Scottsdale, AZ
  • NPI 1730388828
  NPD (past)

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

{
    "created_epoch": "1219708800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1219708800000",
    "number": "1386891877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1822 S 39TH ST UNIT 25",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852063828",
            "telephone_number": "480-926-2868"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1196 E ALTADONNA ST",
            "city": "QUEEN CREEK",
            "state": "AZ",
            "postal_code": "852407846",
            "telephone_number": "480-274-3951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "JULIE",
        "middle_name": "ANN",
        "credential": "MS OTR/L",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-08-26",
        "last_updated": "2008-08-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "AZ",
            "license": "3944",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Raven Nicole Taylor, PHYSICIAN ASSISTANT
• Sasha Mathews Taylor, NMD
• Teri Johnson Training Consulting
• Terravella Assisted Living Care LLC
• Rhonda Cheryll Cigaral Teston, MSN
• Madelyn Thayer
• The Healing Space PLLC
• The House of Change
• Therapeutic Consulting Services
• April Dawn Thomas, SLP

• Occupational Therapist in Queen Creek, AZ
• Providers in Queen Creek, AZ by specialty
• Occupational Therapist in Arizona

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 26, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.