Coralee M. Thacker-Thompson, PNP

Primary specialty

Pediatric Nurse PractitionerTaxonomy code 363LP0200X

License

045482 Issued in MO

Practice address

104 East Highway 60
Mountain View, MO 65548

Phone

(417) 934-2251

Fax

(417) 934-2871

NPI assigned

Oct 19, 2006

Last updated

Jul 15, 2008By the provider in NPPES

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)

Enrolled

Credentials

Nurse Practitioner

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Ozarks Medical Center

  dba Ozarks Healthcare

  • General Acute Care Hospital
  • West Plains, MO
  • NPI 1831115641
  NPD (past)

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

{
    "created_epoch": "1161216000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1780766618",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2580",
            "city": "SPRINGFIELD",
            "state": "MO",
            "postal_code": "658012580",
            "telephone_number": "417-829-4620",
            "fax_number": "417-829-4316"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "104 EAST HIGHWAY 60",
            "city": "MOUNTAIN VIEW",
            "state": "MO",
            "postal_code": "65548",
            "telephone_number": "417-934-2251",
            "fax_number": "417-934-2871"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER-THOMPSON",
        "first_name": "CORALEE",
        "middle_name": "M.",
        "credential": "PNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-19",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "MO",
            "license": "045482",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "426765103",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Russell S Schierling, DC
• Spartan Sleep Studies
• St Francis Hospital (St. John's St Francis Hospital)
• St Francis Hospital (St Francis Home Medical Equipment)
• Patricia Alexa Summerford, APRN
• Wal-Mart Stores East LP (Walmart Pharmacy 100871)
• Walgreen Co (Walgreens # 15054)
• Mary Elizabeth Waterhouse, AGNP-BC
• Whetstone Boys Ranch
• Robert G Wilkie, MD

• Pediatric Nurse Practitioner in Mountain View, MO
• Providers in Mountain View, MO by specialty
• Pediatric Nurse Practitioner in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; 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.