Active NPI
Sophai Thach
- Family Nurse Practitioner
- Saint Louis, MO
National Provider Identifier
1801430442
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Nurse Practitioner
- License
- F09190892
- Practice address
- 9717 Landmark Parkway Dr
Saint Louis, MO 63127-1628 - Phone
- (314) 722-6555
- NPI assigned
- Nov 6, 2019
- 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 |
|---|---|---|---|---|
| Family Nurse Practitioner | 363LF0000X | F09190892 | MO | Primary |
Addresses
Primary practice location
9717 Landmark Parkway Dr
Saint Louis, MO 63127-1628
Mailing address
2090 Hackmann Estates Dr
Saint Charles, MO 63303-4471
Phone (314) 546-3572
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: No
Care Compare profile
Medicare Care Compare- Specialty
- Nurse Practitioner
- Education
- Other, 2019
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
169 Madison Ave
New York, NY 10016-5101
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| F09190892 | MO | MD | Family Nurse Practitioner |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1572998400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1572998400000",
"number": "1801430442",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2090 HACKMANN ESTATES DR",
"city": "SAINT CHARLES",
"state": "MO",
"postal_code": "633034471",
"telephone_number": "314-546-3572"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9717 LANDMARK PARKWAY DR",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631271628",
"telephone_number": "314-722-6555"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACH",
"first_name": "SOPHAI",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-11-06",
"last_updated": "2019-11-06",
"status": "A"
},
"taxonomies": [
{
"code": "363LF0000X",
"taxonomy_group": "",
"desc": "Nurse Practitioner, Family",
"state": "MO",
"license": "F09190892",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 6, 2019; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.