Derek Thacker, M.D.

Primary specialty

Surgery PhysicianTaxonomy code 208600000X

License

61910 Issued in TN

Practice address

395 Hospital Blvd
Jackson, TN 38305-2080

Phone

(731) 664-7395

NPI assigned

May 13, 2014

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in TN

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

General Surgery

Education

University of South Alabama College of Medicine, 2014

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

West Tennessee Medical Group IncGroup PAC ID 3971781006, 190 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Jackson-Madison County General Hospital Hospital, Jackson, TN, CCN 440002
• Dyersburg Regional Medical Center Hospital, Dyersburg, TN, CCN 440072
• West Tennessee Healthcare Henry County Hospital Hospital, Paris, TN, CCN 440132

Merit-based Incentive Payment System (MIPS)

Final score

95.74 of 100Reported as apm

Quality

85.23

Promoting interoperability

100

Improvement activities

40

Procedures performed for Medicare patients

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

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.

• West Tennessee Medical Group Inc

  • Internal Medicine Physician
  • Jackson, TN
  • NPI 1053615955
  Medicare reassignment Care Compare group NPD

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Dyersburg Health

  • Community/Retail Pharmacy
  • Dyersburg, TN
  • NPI 1043282338

  Hospital

  Care Compare affiliation
• Jackson Madison County General Hospital

  • General Acute Care Hospital
  • Jackson, TN
  • NPI 1093705428
  Care Compare affiliation
• West Tennessee Healthcare Henry County

  • General Acute Care Hospital
  • Paris, TN
  • NPI 1497750244
  Care Compare affiliation

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

{
    "created_epoch": "1399939200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1615420800000",
    "number": "1538570544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 FLEETS ISLAND DR",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381039019",
            "telephone_number": "256-606-8372"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 HOSPITAL BLVD",
            "city": "JACKSON",
            "state": "TN",
            "postal_code": "383052080",
            "telephone_number": "731-664-7395"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2500 N State St",
            "address_2": "Department of Surgery",
            "address_purpose": "LOCATION",
            "city": "Jackson",
            "state": "MS",
            "postal_code": "392164500",
            "country_code": "US",
            "telephone_number": "601-984-5101",
            "fax_number": "901-984-5110",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THACKER",
        "first_name": "DEREK",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-13",
        "last_updated": "2021-03-11",
        "certification_date": "2021-03-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "TN",
            "license": "61910",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Krittika Thakuria, DO
• Leah Tharpe, RN0000144089
• The Cardiovascular Clinic of West Tennessee,P.C.
• The Children'S Clinic of West Tennessee P.a.
• The David Vickery Limited Partnership

• Surgery Physician in Jackson, TN
• Providers in Jackson, TN by specialty
• Surgery Physician in Tennessee

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 11, 2021; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.