Sarah Thacker, RN, PHN

Primary specialty

Registered NurseTaxonomy code 163W00000X

License

2219394 Issued in MN

Practice address

118 Main Ave N
New York Mills, MN 56567-4405

Phone

(218) 385-5507

NPI assigned

May 15, 2017

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Registered Nurse

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.

• Otter Tail County Auditor

  • Public Health or Welfare Agency
  • Fergus Falls, MN
  • NPI 1023001260
  NPD (past)
• Otter Tail County Public Health

  • Public Health or Welfare Agency
  • New York Mills, MN
  • NPI 1164730362
  NPD (past)

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

{
    "created_epoch": "1494806400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1494806400000",
    "number": "1700313301",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 99",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565670099"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "118 MAIN AVE N",
            "city": "NEW YORK MILLS",
            "state": "MN",
            "postal_code": "565674405",
            "telephone_number": "218-385-5507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "SARAH",
        "credential": "RN, PHN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-05-15",
        "last_updated": "2017-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163W00000X",
            "taxonomy_group": "",
            "desc": "Registered Nurse",
            "state": "MN",
            "license": "2219394",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "2219394",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Sanford Clinic North
• Sanford Medical Center Fargo
• Thomas M Seaworth, MD
• Seip Drug LLC
• Nathan L Seip, RPH
• Julie Ann Tobkin, FNP
• Carrie Ugstad
• Josephine Annette Wigert, R.N.
• Joann Winjum
• Jessica Witt, MS, CCC-SLP

• Registered Nurse in New York Mills, MN
• Providers in New York Mills, MN by specialty
• Registered Nurse in Minnesota

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2017; 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.