Brian Thacker, HIS

Primary specialty

Hearing Instrument SpecialistTaxonomy code 237700000X

License

AS5734 Issued in FL

Practice address

7110 Cypress Gardens Blvd
Winter Haven, FL 33884-3216

Phone

(863) 324-2288

NPI assigned

Aug 30, 2023

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

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.

• Metampa, LLC

  • Hearing Instrument Specialist
  • Winter Haven, FL
  • NPI 1275011389
  NPD (past)
• Metampa, LLC

  • Hearing Instrument Specialist
  • Brandon, FL
  • NPI 1528546728
  NPD (past)

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

{
    "created_epoch": "1693353600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693353600000",
    "number": "1548045222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7110 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843216",
            "telephone_number": "863-324-2288"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7110 CYPRESS GARDENS BLVD",
            "city": "WINTER HAVEN",
            "state": "FL",
            "postal_code": "338843216",
            "telephone_number": "863-324-2288"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "BRIAN",
        "credential": "HIS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-08-30",
        "last_updated": "2023-08-30",
        "certification_date": "2023-08-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "237700000X",
            "taxonomy_group": "",
            "desc": "Hearing Instrument Specialist",
            "state": "FL",
            "license": "AS5734",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Tameka Taylor
• Anna Tedesco
• Tender Loving Care Health Care Services of Broward, LLC
• Tender Loving Care Home Agency LLC
• Alivia Michelle Terriaca, LMHC
• The Barranco Clinic
• The Barranco Clinic, P.a.
• The Center for Functional Aesthetic and Anti Aging Medicine Inc
• The Graceful Hope Foundation
• The Health Coach, LLC

• Hearing Instrument Specialist in Winter Haven, FL
• Providers in Winter Haven, FL by specialty
• Hearing Instrument Specialist in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 30, 2023; 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.