Brandon Thacker

Primary specialty

Community Health WorkerTaxonomy code 172V00000X

Practice address

2608 W Riggin Rd
Muncie, IN 47304-1019

Phone

(317) 445-0336

NPI assigned

Mar 30, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

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.

• New Beginnings Services LLC

  • Community Health Worker
  • Muncie, IN
  • NPI 1760174551
  NPD Authorized official
• Advanced Family Preservation, LLC

  • Social Worker
  • Muncie, IN
  • NPI 1861151227
  NPD

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

{
    "created_epoch": "1648598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649376000000",
    "number": "1851031504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2608 W RIGGIN RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041019",
            "telephone_number": "317-445-0336"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2608 W RIGGIN RD",
            "city": "MUNCIE",
            "state": "IN",
            "postal_code": "473041019",
            "telephone_number": "317-445-0336"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "BRANDON",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-03-30",
        "last_updated": "2022-04-08",
        "certification_date": "2022-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106S00000X",
            "taxonomy_group": "",
            "desc": "Behavior Technician",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "172V00000X",
            "taxonomy_group": "",
            "desc": "Community Health Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "advancedfamilypreservation@outlook.com",
            "affiliation": "N",
            "endpointDescription": "advancedfamilypreservation@outlook.com",
            "address_1": "2608 W Riggin Rd",
            "city": "Muncie",
            "state": "IN",
            "country_code": "US",
            "postal_code": "473041019",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Technical Gas Products, Inc
• Jessica Marie Templeton, PA-C
• Trevor Allen Tennison
• Christina Ann Tennyson, M.D.
• Teresa M Watkins DDS
• Christina Thacker, LSW
• Emily Thalls
• Simant Singh Thapa, MD
• Jordan Lynn Tharp, CAA
• Karen L Thatcher, ED.D., CCC-SLP

• Community Health Worker in Muncie, IN
• Providers in Muncie, IN by specialty
• Community Health Worker in Indiana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 8, 2022; 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.