Tobe Thacker

Primary specialty

ChiropractorTaxonomy code 111N00000X

License

CHIA-1704 Issued in ID

Legal business name

TOBE THACKER

Doing business as

Broken Bow Chiropractic

Practice address

1605 S Park Dr
Broken Bow, OK 74728-5724

Phone

(580) 584-3385

NPI assigned

Feb 11, 2016

Last updated

Jan 14, 2020By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Dr. Tobe Thacker, DCNPI 1215396874

Title

Owner

Phone

(580) 584-3385

Specialties & licenses 1

Addresses

Other names 1

• Broken Bow Chiropractic Doing business as

Locations

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Tobe Thacker, D.C.

  • Chiropractor
  • Broken Bow, OK
  • NPI 1215396874
  Authorized official Same address or phone
• Adam Kenneth Mills, DC

  • Chiropractor
  • Coeur d'Alene, ID
  • NPI 1003212069
  NPD (past)

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

{
    "created_epoch": "1455148800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1578960000000",
    "number": "1871952481",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1605 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285724",
            "telephone_number": "580-584-3385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1605 S PARK DR",
            "city": "BROKEN BOW",
            "state": "OK",
            "postal_code": "747285724",
            "telephone_number": "580-584-3385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOBE THACKER",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-02-11",
        "last_updated": "2020-01-14",
        "certification_date": "2020-01-14",
        "status": "A",
        "authorized_official_last_name": "THACKER",
        "authorized_official_first_name": "TOBE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "580-584-3385",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "ID",
            "license": "CHIA-1704",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Broken Bow Chiropractic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Pierre Francis Taron III, D.C.
• Texarkana Eye Associates-Broken Bow Branch
• Tobe Thacker, D.C.
• Three Rivers Consulting & Management ,LLC (Complete Hospice Care of Eastern Oklahoma)
• TLC Family Clinic, LLC
• Sarah Todd
• Renisa Underwood
• Catherine Valencia, LPC
• Wal-Mart Stores East LP (Walmart Pharmacy 10-0117)
• Mitchell Ally Wallis

• Chiropractor in Broken Bow, OK
• Providers in Broken Bow, OK by specialty
• Chiropractor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 14, 2020; 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.