Robert Slade Thacker, APRN CFNP | |
1906 Fairview Ave, Ste. 230, Caldwell, ID 83605-5407 | |
(208) 459-4667 | |
Not Available |
Full Name | Robert Slade Thacker |
---|---|
Gender | Male |
Speciality | Nurse Practitioner |
Experience | 13 Years |
Location | 1906 Fairview Ave, Caldwell, Idaho |
Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
Identifier | Type | State | Issuer |
---|---|---|---|
1124309224 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
363LF0000X | Nurse Practitioner - Family | NP-1096A (Idaho) | Primary |
Facility Name | Location | Facility Type |
---|---|---|
West Valley Medical Center | Caldwell, ID | Hospital |
St Luke's Nampa Medical Center | Nampa, ID | Hospital |
St Luke's Regional Medical Center | Boise, ID | Hospital |
Saint Alphonsus Medical Center - Nampa | Nampa, ID | Hospital |
Group Practice Name | Group PECOS PAC ID | No. of Members |
---|---|---|
West Valley Medical Group Llc | 8729180310 | 12 |
Entity Name | West Valley Medical Group Llc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1871673798 PECOS PAC ID: 8729180310 Enrollment ID: O20070228000567 |
Entity Name | Carepoint Health Emergency Medicine Idaho Pllc |
---|---|
Entity Type | Part B Supplier - Clinic/group Practice |
Entity Identifiers | NPI Number: 1285275461 PECOS PAC ID: 6406283860 Enrollment ID: O20200224002457 |
Mailing Address | Practice Location Address |
---|---|
Robert Slade Thacker, APRN CFNP 1906 Fairview Ave, Ste. 230, Caldwell, ID 83605-5407 Ph: (208) 459-4667 | Robert Slade Thacker, APRN CFNP 1906 Fairview Ave, Ste. 230, Caldwell, ID 83605-5407 Ph: (208) 459-4667 |
Cynthia Jane Floyd, FNP-BC Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 15076 Plum Rd, Caldwell, ID 83607 Phone: 208-830-5560 | |
Matthew Fowler, AGNP-C Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 211 E Logan St Ste 301, Caldwell, ID 83605 Phone: 208-649-4315 Fax: 208-649-4513 | |
Ashley Fae White, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1717 Arlington Ave, Caldwell, ID 83605 Phone: 208-459-4641 | |
Mrs. Deborah Lee Sullivan, ARNP Nurse Practitioner Medicare: Medicare Enrolled Practice Location: 211 E Logan St, Suite 105, Caldwell, ID 83605 Phone: 208-454-0567 Fax: 208-402-6635 | |
Lynette Joy Ages, NP Nurse Practitioner Medicare: Accepting Medicare Assignments Practice Location: 1818 S 10th Ave Ste 200, Caldwell, ID 83605 Phone: 208-453-6417 Fax: 208-453-6419 | |
Crystal Gail Belcourt, CPNP-PC Nurse Practitioner Medicare: Not Enrolled in Medicare Practice Location: 1620 S Kimball Ave, Caldwell, ID 83605 Phone: 208-505-2950 Fax: 208-505-2955 |