Antoinette M Thacker, LISW-S

Primary specialty

Social WorkerTaxonomy code 104100000X

License

I.1000009-SUPV Issued in OH

Practice address

1910 Fairgrove Ave Ste E
Hamilton, OH 45011-1930

Phone

(513) 795-7557

Fax

(513) 737-4603

NPI assigned

Jul 12, 2013

Last updated

Nov 1, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in OH

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://api.platform.athenahealth.com/5507/brand/1/csg/1/fhir/r4
• FHIR API: https://api.qualifacts.org/api/fhir/mpwhealth/r4/

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Greater Cincinnati Behavioral Health Services

  • Community/Behavioral Health Agency
  • Walnut Hills, OH
  • NPI 1720251788
  Medicare reassignment NPD
• Modern Psychiatry and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1225260888
  Medicare reassignment NPD
• Absolutecare of Ohio, LLC

  • Multi-Specialty Clinic/Center
  • Columbus, OH
  • NPI 1003544495
  NPD
• Absolutecare of Ohio, LLC

  • Multi-Specialty Clinic/Center
  • Brooklyn, OH
  • NPI 1619605672
  NPD
• Greater Cincinnati Behavioral Health Services

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Walnut Hills, OH
  • NPI 1588626097
  NPD
• Greater Cincinnati Behavioral Health Services

  • Family Medicine Physician
  • Cincinnati, OH
  • NPI 1871486183
  NPD
• Modern Psychiatry & Wellness, LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1699251553
  NPD

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

{
    "created_epoch": "1373587200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1667260800000",
    "number": "1750722286",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8778 COTTONWOOD DR",
            "city": "CINCINNATI",
            "state": "OH",
            "postal_code": "452314706",
            "telephone_number": "513-305-2218",
            "fax_number": "513-737-4603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1910 FAIRGROVE AVE STE E",
            "city": "HAMILTON",
            "state": "OH",
            "postal_code": "450111930",
            "telephone_number": "513-795-7557",
            "fax_number": "513-737-4603"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8778 Cottonwood Dr",
            "address_purpose": "LOCATION",
            "city": "Cincinnati",
            "state": "OH",
            "postal_code": "452314706",
            "country_code": "US",
            "telephone_number": "513-305-2218",
            "fax_number": "513-737-4603",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THACKER",
        "first_name": "ANTOINETTE",
        "middle_name": "M",
        "credential": "LISW-S",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-07-12",
        "last_updated": "2022-11-01",
        "certification_date": "2022-11-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1000009-SUPV",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1000009-SUPV",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Alice Terrell
• Kelsey Terry, LPN
• Marilyn None Terry, LPN
• Aimee Rose Terzo, RN
• Amy Tevault, MA, LPCC
• Edward Thatcher
• The Fort Hamilton Hospital (Kettering Health Hamilton)
• The Fort Hamilton Hospital (Ft. Hamilton Cardiology)
• The Fort Hamilton Hospital (Kettering Health Hamilton Inpatient Rehab Unit)
• The Fort Hamilton Hospital (Kettering Health Pharmacy Hamilton)

• Social Worker in Hamilton, OH
• Providers in Hamilton, OH by specialty
• Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 1, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.