MS. AMANDA MARIE THACKER (NPI# 1811421498) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1811421498 |
| Entity Type | Individual |
| Full Name | MS. AMANDA MARIE THACKER |
| Credential | D.C. |
| Practice Address |
N 5241 Us Hwy 45 Watersmeet MI 49969 |
| Practice Telephone | 9063584588 |
| Practice Fax Number | 9063584118 |
| Mailing Telephone | 9063584588 |
| Mailing Fax Number | 9063584118 |
| Enumeration Date | 2017-04-20 |
| Last Update Date | 2018-10-22 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 111N00000X | Chiropractor | 03916 | MD | Chiropractic Providers |
| Y | 111NI0013X |
Chiropractor Specialization: Independent Medical Examiner |
2301010656 | MI | Chiropractic Providers |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982221974 | Amanda Gail Thacker | Behavior Technician | 34 N Washington St, Ardmore, OK 73401-7013 | 2020-06-25 |
| 1932536117 | Amanda Thacker | Counselor | 100 W Columbia St, Orlando, FL 32806-1006 | 2013-10-02 |
| Street Address |
N 5241 US HWY 45 |
| City | WATERSMEET |
| State | MI |
| Zip Code | 49969 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1811363690 | Lisa Meza | Physician Assistant | E23970 Pow Wow Trail, Watersmeet, MI 49969 | 2015-08-17 |
| 1275713570 | Maurice Anthony Shively | Dentist | E23970 Pow Wow Trail Rd, Watersmeet, MI 49969 | 2007-11-05 |
| 1093781668 | Steven J Fiorucci | Family Medicine | N4698 Highway 45, Watersmeet, MI 49969 | 2006-02-24 |
| 1851383525 | Gary M Pusateri | General Practice | E23570 Pow Wow Tr., Watersmeet, MI 49969 | 2005-08-18 |
| 1245695899 | Grady O'neill | Counselor | E23970 Pow Wow Trail, Watersmeet, MI 49969 | 2015-12-28 |
| 1396126736 | Lac Vieux Desert Tribal Council | Optometrist | E23970 Pow Wow Trl, Watersmeet, MI 49969-0249 | 2015-06-11 |
| 1972862852 | Charissa Ann Jeske | Counselor | E23968 Powwow Trl, Watersmeet, MI 49969-0249 | 2012-05-11 |
| 1811197304 | Patti M Paige | Nurse Practitioner | E23570 Choate Road, Watersmeet, MI 49969-0249 | 2007-07-23 |
| 1952455321 | Kim Ivey | Pharmacist | N5241 Us Hwy 45, Watersmeet, MI 49969-0249 | 2007-01-23 |
| 1952319832 | Mark R Bognar | Dentist | E 23970 Pow Wow Trail Rd, Lac Vieux Desert Health Center, Watersmeet, MI 49969-0249 | 2006-08-04 |
| Find all providers in zip 49969 | ||||
| Taxonomy Code | 111NI0013X |
| Grouping | Chiropractic Providers |
| Classification | Chiropractor |
| Specialization | Independent Medical Examiner |
| A special evaluator not involved with the medical care of the individual examinee that impartially evaluates the care being provided by other practitioners to clarify clinical, disability, liability or other case issues. |
| Notes: Source: American Board of Independent Medical Examiners [1/1/2007: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1801205745 | Procare Injury & Rehab Centers LLC | Chiropractor | 1289 S Linden Rd, Ste A, Flint, MI 48532-3499 | 2014-08-05 |
| 1598030728 | Roberts Chiropractic Life Center, Pllc | Chiropractor | 13301 Reeck Ct Ste 1a, Southgate, MI 48195-3054 | 2012-03-21 |
| 1255689782 | Pointes Chiropractic Clinic Inc | Chiropractor | 15761 Mack Ave, Detroit, MI 48224-3479 | 2012-08-15 |
| 1053618645 | Dr Deana Lajiness Dc LLC | Chiropractor | 2909 Walton Blvd, Rochester Hills, MI 48309-1419 | 2011-02-17 |
| 1154574028 | Gerard Edward Farage | Chiropractor | 1715 4 Mile Rd Ne, Grand Rapids, MI 49525-2440 | 2008-10-23 |
| 1023234754 | Rudolph Garza | Chiropractor | 1152 Burton St Se, Grand Rapids, MI 49507-3359 | 2007-04-18 |
| City | WATERSMEET |
| Zip Code | 49969 |
Please comment or provide details below to improve the information on MS. AMANDA MARIE THACKER.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.