MRS. TERESA YVONNE THACKER MD NPI 1891875274

NPI Information

NPI: 1891875274
Provider Name: MRS. TERESA YVONNE THACKER, MD
Classification: Family Medicine - 207Q00000X
Entity Type: Individual

PECOS Registration: Yes

Address:
1155 MAIN ST
MILTON, WV
ZIP 25541
Phone: (304) 743-8833
Get Directions

MRS. Teresa Yvonne Thacker, MD is a family medicine in Milton, WV with 34 years of experience. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. MRS. Teresa Yvonne Thacker, MD NPI is 1891875274. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

1155 MAIN ST
MILTON, WV
ZIP 25541-217
Phone: (304) 743-8833
Fax: (304) 743-8834

The NPI 1891875274 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment, Part A Home Health Agency (HHA), Power Mobility Devices.

The enumeration date for this NPI number is 10/17/2006 and was last updated on 6/15/2015.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	207Q00000X	Family Medicine		17431	WEST VIRGINIA	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	001721893	OTHER	WEST VIRGINIA	BCBS
2	0053757000	MEDICAID	WEST VIRGINIA
3	080174378	OTHER	WEST VIRGINIA	TRAVLERS MEDICARE
4	F65772	MEDICARE UPIN	WEST VIRGINIA
5	0746654	MEDICARE PIN	WEST VIRGINIA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

NPI Synchronization or Removal

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