David Harold Thacker I, SOIDC

Primary specialty

Independent Duty CorpsmanTaxonomy code 1710I1002X

Practice address

2D Reconnaissance Battalion, II Mef
PSC Box 20138
Camp Lejeune, NC 28542-0138

Phone

(910) 440-7719

NPI assigned

Jul 24, 2009

Sex

Male

Sole proprietor

No

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

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

{
    "created_epoch": "1248393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1248393600000",
    "number": "1528298478",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2D RECONNAISSANCE BATTALION",
            "address_2": "PSC BOX 20138",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420138",
            "telephone_number": "910-440-7719"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2D RECONNAISSANCE BATTALION, II MEF",
            "address_2": "PSC BOX 20138",
            "city": "CAMP LEJEUNE",
            "state": "NC",
            "postal_code": "285420138",
            "telephone_number": "910-440-7719"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "DAVID",
        "middle_name": "HAROLD",
        "name_prefix": "Mr.",
        "name_suffix": "I",
        "credential": "SOIDC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2009-07-24",
        "last_updated": "2009-07-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1710I1002X",
            "taxonomy_group": "",
            "desc": "Military Health Care Provider, Independent Duty Corpsman",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Gayle Taaca Tatro, PHARM.D.
• Aaron M Taylor, M.D.
• Michael Salvatore Termini, MD
• Eric Terpstra, DO
• Jacob Testa, IDC
• Kristen A Thacker, MSED, LAT, ATC
• The Janz Corporation (Janz Medical Supply)
• Dylan Andrew Thomas
• Kimberly A Thomas, NP-C
• Rafaela Thomas, NP

• Independent Duty Corpsman in Camp Lejeune, NC
• Providers in Camp Lejeune, NC by specialty
• Independent Duty Corpsman in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2009; 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.