Active NPI
Chadward Thacker, MD
- Family Medicine Physician
- Pikeville, KY
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- 38711
- Practice address
- 140 Adams LN Ste 600-700
Pikeville, KY 41501-3087 - Phone
- (606) 509-2000
- Fax
- (606) 509-2002
- NPI assigned
- Jul 13, 2006
- Last updated
- Jan 26, 2024
- Sex
- Male
- Sole proprietor
- Yes
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 Medicine Physician | 207Q00000X | 38711 | KY | Primary |
Addresses
Primary practice location
140 Adams LN Ste 600-700
Pikeville, KY 41501-3087
Mailing address
PO Box 1228
Pikeville, KY 41502-1228
Phone (606) 509-2000
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 64092638 | Medicaid | KY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in KY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: Yes
- Power mobility devices: Yes
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Family Practice
- Education
- University of Kentucky College of Medicine, 1997
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
140 Adams LN
Suite 600 700
Pikeville, KY 41501-3087
Phone (606) 509-2000
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- HHS exclusion list flag
- CMS’s directory marks this NPI as on an HHS exclusion list; no matching OIG record was found.
- Credentials
- Doctor of Medicine
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Thacker Family Medical LLC | Family Medicine | Current | Accepting new patients |
Locations
140 Adams Ln
Ste 600700
Pikeville, KY 41501
Phone (606) 218-4793
Interoperability endpoints
- cthacker@thackerfamily.qrsdm.com
Ownership & related parties
All facility ownership & control disclosures 1
Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.
| Facility | Type | Role | Since |
|---|---|---|---|
| Thacker Family Medical LLC | Rural health clinic | 5% Or Greater Direct Ownership Interest (100%) Corporate Officer (100%) Operational/Managerial Control (100%) |
Feb 14, 2012 Feb 14, 2012 Feb 14, 2012 |
Owned or controlled facilities with NPI records 1
Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.
-
- Rural Health Clinic/Center
- Pikeville, KY
- NPI 1134898364
5% Or Greater Direct Ownership Interest, Corporate Officer, Operational/Managerial Control
Organizations & group practices 3
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.
-
- Family Medicine Physician
- Pikeville, KY
- NPI 1629342985
-
- Rural Health Clinic/Center
- Pikeville, KY
- NPI 1134898364
-
- Family Medicine Physician
- Pikeville, KY
- NPI 1124596341
Hospital & facility affiliations 2
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
- Home Health Agency
- Pikeville, KY
- NPI 1528028487
-
- General Acute Care Hospital
- Pikeville, KY
- NPI 1285621623
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152748800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1706227200000",
"number": "1801811542",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 1228",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415021228",
"telephone_number": "606-509-2000",
"fax_number": "606-509-2002"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "140 ADAMS LN STE 600-700",
"city": "PIKEVILLE",
"state": "KY",
"postal_code": "415013087",
"telephone_number": "606-509-2000",
"fax_number": "606-509-2002"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THACKER",
"first_name": "CHADWARD",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-13",
"last_updated": "2024-01-26",
"certification_date": "2024-01-26",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "KY",
"license": "38711",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "64092638",
"state": "KY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Pikeville, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data; 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.