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

Sex

Female

Sole proprietor

Yes

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.

• Greater Cincinnati Behavioral Health Services

  • Community/Behavioral Health Agency
  • Walnut Hills, OH
  • NPI 1720251788

  OH

  Medicare reassignment NPD
• Modern Psychiatry and Wellness LLC

  • Adult Mental Health Clinic/Center
  • Hamilton, OH
  • NPI 1225260888

  OH

  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

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

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/

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 1, 2022.

{
    "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": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.1000009-SUPV",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "OH",
            "license": "I.1000009-SUPV",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kenneth Tepe, MD
• Alice Terrell
• Kelsey Terry, LPN
• Marilyn None Terry, LPN
• Aimee Rose Terzo, RN
• Edward Thatcher
• The Fort Hamilton Hospital
• The Fort Hamilton Hospital
• The Fort Hamilton Hospital
• The Fort Hamilton Hospital

• All providers in Hamilton, OH
• 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.