Individual provider Active NPI

Jincy Thankachan

  • Acute Care Nurse Practitioner
  • Sugar Land, TX
National Provider Identifier
1841860871
Registry record updated Jul 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Acute Care Nurse PractitionerTaxonomy code 363LA2100X
License
1042600 Issued in TX
Practice address
14954 Sugar Sands Dr
Sugar Land, TX 77498-5034
Phone
(832) 955-8175
NPI assigned
Jul 1, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 1, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Acute Care Nurse Practitioner 363LA2100X 1042600 TX Primary

Addresses

Primary practice location

14954 Sugar Sands Dr
Sugar Land, TX 77498-5034

Mailing address

14954 Sugar Sands Dr
Sugar Land, TX 77498-5034
Phone (832) 955-8175

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231026000707 TX Practitioner - Nurse Practitioner 6103272224 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
1042600TXMDAcute Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
City of Houston CurrentSince May 22, 2023 Accepting new patients
City of Houston Current Accepting new patients
City of Houston CurrentSince May 22, 2023 Accepting new patients

Locations

4410 Reed Rd
Houston, TX 77051
Phone (832) 395-0069

1809 N Main St
Houston, TX 77009
Phone (713) 547-8076

8000 N Stadium Dr
Fl 7
Houston, TX 77054
Phone (713) 794-9104

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1625097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625097600000",
    "number": "1841860871",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "14954 SUGAR SANDS DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774985034",
            "telephone_number": "832-955-8175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14954 SUGAR SANDS DR",
            "city": "SUGAR LAND",
            "state": "TX",
            "postal_code": "774985034",
            "telephone_number": "832-955-8175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THANKACHAN",
        "first_name": "JINCY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-07-01",
        "last_updated": "2021-07-01",
        "certification_date": "2021-05-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LA2100X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Acute Care",
            "state": "TX",
            "license": "1042600",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sugar Land, TX

Sources for this page

Verify at the official NPI Registry.