Kelsey Marie Thacker, | |
104 E Ashland Ave, Mt Zion, IL 62549-1271 | |
(217) 864-2665 | |
(217) 864-8042 |
Full Name | Kelsey Marie Thacker |
---|---|
Gender | Female |
Speciality | Nurse Practitioner |
Experience | 9 Years |
Location | 104 E Ashland Ave, Mt Zion, Illinois |
Accepts Medicare Assignments | Yes. She accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1245765296 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363L00000X | Nurse Practitioner | 209015926 (Illinois) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
Decatur Memorial Hospital | Decatur, IL | Hospital |
St Marys Hospital | Decatur, IL | Hospital |
Pana Community Hospital | Pana, IL | Hospital |
Kirby Medical Center | Monticello, IL | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
Pana Community Hospital Association | 3274437348 | 53 |
Decatur Orthopedic Center Llc | 4981844289 | 8 |
Kirby Medical Center | 6901791144 | 53 |
Entity Name | Pana Community Hospital Association |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1942326970 PECOS PAC ID: 3274437348 Enrollment ID: O20031121000350 |
Entity Name | Kirby Medical Center |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1386635373 PECOS PAC ID: 6901791144 Enrollment ID: O20050801000320 |
Entity Name | Decatur Orthopedic Center Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1336586114 PECOS PAC ID: 4981844289 Enrollment ID: O20130710000446 |
Mailing Address | Practice Location Address |
---|---|
Kelsey Marie Thacker, 104 Ashland Avenue, Mt. Zion, IL 62549 Ph: (217) 864-2665 | Kelsey Marie Thacker, 104 E Ashland Ave, Mt Zion, IL 62549-1271 Ph: (217) 864-2665 |
Julia K Auton, APN Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1200 N State Highway 121, Mt Zion, IL 62549 Phone: 217-864-5531 Fax: 217-864-2449 | |
Katelyn Keller, APRN Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1410 E Village Pkwy, Mt Zion, IL 62549 Phone: 217-855-7447 | |
Kim Miller, APN/CNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 1200 N State Highway 121, Mt Zion, IL 62549 Phone: 217-864-5531 Fax: 217-864-2449 | |
Joseph Thomas Meyers, MSN, APN, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 104 E Ashland Ave, Mt Zion, IL 62549 Phone: 217-864-2665 | |
Jenna Nicole Stowers, APRN-FPA, FNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 100 Lewis Park Dr, Mt Zion, IL 62549 Phone: 217-855-7447 Fax: 888-774-7504 | |
Kayla Michelle Sheets, NP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 104 E Ashland Ave, Mt Zion, IL 62549 Phone: 217-864-2665 |