Active NPI
Melissa Dawn Thacker, P.T.
- Physical Therapist
- Altus, OK
National Provider Identifier
1720306145
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 4298
- Practice address
- 301 E Broadway St
Altus, OK 73521-5507 - Phone
- (405) 609-3675
- Fax
- (800) 506-3795
- NPI assigned
- May 10, 2010
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 4298 | OK | Primary |
Addresses
Primary practice location
301 E Broadway St
Altus, OK 73521-5507
Mailing address
700 NW 7TH St
Suite 304
Oklahoma City, OK 73102-1212
Phone (405) 609-3675
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 4298 | OK | MD | Chiropractor |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Valir Outpatient Clinics LLC | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Physical Therapist
- Shawnee, OK
- NPI 1245765536
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1273449600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1373500800000",
"number": "1720306145",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "700 NW 7TH ST",
"address_2": "SUITE 304",
"city": "OKLAHOMA CITY",
"state": "OK",
"postal_code": "731021212",
"telephone_number": "405-609-3675",
"fax_number": "800-506-3795"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "301 E BROADWAY ST",
"city": "ALTUS",
"state": "OK",
"postal_code": "735215507",
"telephone_number": "405-609-3675",
"fax_number": "800-506-3795"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "MELISSA",
"middle_name": "DAWN",
"credential": "P.T.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2010-05-10",
"last_updated": "2013-07-11",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "OK",
"license": "4298",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Altus, OK
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.