Thacker Family Medical LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

38711 Issued in KY

Legal business name

THACKER FAMILY MEDICAL LLC

Practice address

140 Adams LN
Suite 600-700
Pikeville, KY 41501-3087

Phone

(606) 509-2000

Fax

(606) 509-2002

NPI assigned

Mar 5, 2012

Organization subpart

No

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

Authorized official

Name

Dr. Chadward L. Thacker, M.D.NPI 1801811542

Title

Soile Member/Owner

Phone

(606) 509-2000

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in KY

Enrollment records 1

Other NPIs with the same Medicare PAC ID 1

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

• Thacker Family Medical LLC

  • Rural Health Clinic/Center
  • Pikeville, KY
  • NPI 1134898364

  1557523057

  Same PAC ID

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Chadward Thacker, MD

  • Family Medicine Physician
  • Pikeville, KY
  • NPI 1801811542
  Medicare reassignment Care Compare group NPD Authorized official
• Billie Bartley, PAC

  • Physician Assistant
  • Pikeville, KY
  • NPI 1184688855
  Medicare reassignment

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

{
    "created_epoch": "1330905600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491868800000",
    "number": "1629342985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1228",
            "address_2": "140 ADAMS LANE, SUITE 600-700",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415021228",
            "telephone_number": "606-509-2000",
            "fax_number": "606-509-2002"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "140 ADAMS LN",
            "address_2": "SUITE 600-700",
            "city": "PIKEVILLE",
            "state": "KY",
            "postal_code": "415013087",
            "telephone_number": "606-509-2000",
            "fax_number": "606-509-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THACKER FAMILY MEDICAL LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-05",
        "last_updated": "2017-04-11",
        "status": "A",
        "authorized_official_last_name": "THACKER",
        "authorized_official_first_name": "CHADWARD",
        "authorized_official_middle_name": "L.",
        "authorized_official_title_or_position": "SOILE MEMBER/OWNER",
        "authorized_official_telephone_number": "606-509-2000",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "KY",
            "license": "38711",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sherri Micheall Taylor
• Staci Taylor, APRN
• Teal Group PLLC
• Teal Group, PLLC
• Thacker Family Medical LLC
• Thacker Family Medical, PLLC
• Andrew Blake Thacker
• Bridget Denise Thacker, LPN
• Brittany Thacker, BCBA-D
• Chadward Thacker, MD

• Family Medicine Physician in Pikeville, KY
• Providers in Pikeville, KY by specialty
• Family Medicine Physician in Kentucky

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.