Christina Thacker, FNP-C
Individual provider Active NPI Family Nurse Practitioner · Roosevelt, UT
NPI 1699225730 · NPPES record last updated Jan 25, 2023
Key facts
- NPI
- 1699225730
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Family Nurse Practitioner 363LF0000X
- License
- 190006-4405 (UT)
- Practice address
- 250 W 300 N
Roosevelt, UT 84066-2336 - Phone
- (435) 722-4691
- NPI assigned
- Oct 13, 2016
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 6
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Nurse Practitioner
- Education
- Other, 2016
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Ashley Valley Family Practice
Practice addresses (Care Compare)
872 W Hwy 40
Vernal, UT 84078-2416
Phone (435) 781-8899
Hospital & facility affiliations
- Uintah Basin Medical Center
- Ashley Regional Medical Center
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20161118000870 | UT | Practitioner - Nurse Practitioner | 3476832262 | Reassigns benefits to 4 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 190006-4405 | UT | MD | Family Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Uintah Basin Medical Center | Current |
Accepting new patients | |
| Uintah Basin Medical Center | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients | |
| Ashley Valley Family Practice | Current |
Accepting new patients | |
| Revere Health PC | Current |
Accepting new patients | |
| Vernal Urgent Care LLC | Current |
Accepting new patients |
Locations
50 E 200 S
Duchesne, UT 84021
Phone (435) 738-2426
1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000
250 W 300 N
#752
Roosevelt, UT 84066
Phone (435) 722-4691
250 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691
210 W 300 N
Roosevelt, UT 84066
Phone (435) 722-4691
210 W 300 N
#753
Roosevelt, UT 84066
Phone (435) 722-3971
175 N 100 W
Ste 103
Vernal, UT 84078
Phone (435) 781-8899
872 W Highway 40
Vernal, UT 84078
Phone (435) 781-8899
379 N 500 W
Ste 1B
Vernal, UT 84078
Phone (801) 377-4623
Interoperability endpoints
- eic4451@yourcarecommunity.org
- christinathacker@cuccu.allscriptsdirect.net
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | 190006-4405 | UT | Yes |
Addresses
Primary practice location
250 W 300 N
Roosevelt, UT 84066-2336
Mailing address
2561 E 1500 S
Vernal, UT 84078-9137
Phone (435) 828-5954
Other providers in Roosevelt, UT
- Peter Lee Tanner
- Alicia E Taylor
- Kayla Elaine Taylor
- Robin L Taylor
- Lori A Teem
- Racquel Thompson
- Samantha Jean Thompson
- Jessica Jean Tibbitts
- Brian Tanner Timberlake
- J. Flint Tomlinson
All providers in Roosevelt, UT · Family Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 25, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.