Individual provider Active NPI

Christopher C Thacker, M.D.

  • Urology Physician
  • Cleveland, TN
National Provider Identifier
1881658664
Registry record updated Oct 23, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
MD34911 Issued in TN
Practice address
400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287
Phone
(423) 472-3201
Fax
(423) 476-4949
NPI assigned
Apr 17, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X MD34911 TN Primary

Addresses

Primary practice location

400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287

Mailing address

400 Berywood TRL NW
Suite B
Cleveland, TN 37312-5287
Phone (423) 472-3201

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TN
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20100927001138 TN Practitioner - Urology 4789700725 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Emory University School of Medicine, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tennessee Valley Urology Center PCGroup PAC ID 2062538077, 6 clinicians

Practice addresses (Care Compare)

400 Berywood Nwtrl B
Cleveland, TN 37312-5288
Phone (423) 472-3201

Hospital & facility affiliations

  • Affiliate of Vitruvian Health Hospital, Cleveland, TN, CCN 440185
  • Starr Regional Medical Center Athens Hospital, Athens, TN, CCN 440068
  • Memorial Healthcare System, Inc Hospital, Chattanooga, TN, CCN 440091
  • Erlanger Medical Center Hospital, Chattanooga, TN, CCN 440104

Merit-based Incentive Payment System (MIPS)

Final score
100 of 100Reported as group
Promoting interoperability
100
Improvement activities
40

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
MD34911TNMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Tennessee Valley Urology Center PC Urology CurrentSince Aug 1, 2001 Accepting new patients

Locations

719 Cook Dr
Ste 110
Athens, TN 37303
Phone (423) 745-2312

400 Berywood Trl NW
Ste B
Cleveland, TN 37312
Phone (423) 472-3201

Interoperability endpoints

  • Direct secure messaging: christopherthacker@tnvalleyuro.medalliesdirect.net
  • Direct secure messaging: dr_christopher_thacker@yourcarecommunity.org

Organizations & group practices 1

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.

Hospital & facility affiliations 5

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1145232000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1193097600000",
    "number": "1881658664",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "400 BERYWOOD TRL NW",
            "address_2": "SUITE B",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125287",
            "telephone_number": "423-472-3201",
            "fax_number": "423-476-4949"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "400 BERYWOOD TRL NW",
            "address_2": "SUITE B",
            "city": "CLEVELAND",
            "state": "TN",
            "postal_code": "373125287",
            "telephone_number": "423-472-3201",
            "fax_number": "423-476-4949"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THACKER",
        "first_name": "CHRISTOPHER",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-04-17",
        "last_updated": "2007-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "TN",
            "license": "MD34911",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Cleveland, TN

Sources for this page

Verify at the official NPI Registry.