JENNA L THACKER


Address: 225 Crosslake Dr, Evansville, IN 47715-8198
Phone: 8124716677

JENNA L THACKER (NPI# 1689929614) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1689929614
Entity Type Individual
Full Name JENNA L THACKER
Other Name JENNA L BETULIUS
Credential OT
Practice Address 225 Crosslake Dr
Evansville
IN 47715-8198
Mailing Address 7300 E Indiana St
Suite 102
Evansville
IN 47715-2794
Practice Telephone 8124716677
Practice Fax Number 8124742296
Mailing Telephone 8124760409
Mailing Fax Number 8124761016
Enumeration Date 2012-07-16
Last Update Date 2014-07-08
Gender Code F
Is Sole Proprietor N

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 225X00000X Occupational Therapist 31005322A IN Respiratory, Developmental, Rehabilitative and Restorative Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
IN BLUE SHIELD BLUE CROSS 000000783241 01
IN 201107090 05
IN BLUE CROSS BLUE SHIELD 000000782655 01
IN BLUE CROSS BLUE SHIELD 000000782963 01

Office Location

Street Address 225 CROSSLAKE DR
City EVANSVILLE
State IN
Zip Code 47715-8198

Providers in the same location

NPI Name Taxonomy Address Enumeration
1104822279 Jacob M O'neill Orthopaedic Surgery 225 Crosslake Dr, Evansville, IN 47715-8198 2005-06-23
1952918419 Mallory Leeann Baker Physical Therapist 225 Crosslake Dr, Evansville, IN 47715-8198 2020-09-29
1558975045 Kurtis D Anthony Nurse Practitioner 225 Crosslake Dr, Evansville, IN 47715-8198 2020-09-02
1487270104 Madison Jo Mundy Occupational Therapist 225 Crosslake Dr, Evansville, IN 47715-8198 2020-06-18
1336774900 Brandi L Fields Nurse Practitioner 225 Crosslake Dr, Evansville, IN 47715-8198 2020-03-04
1982257507 Shelby Clark Physician Assistant 225 Crosslake Dr, Evansville, IN 47715-8198 2019-07-23
1043872013 Jonathan Bernard Kirsch Physical Therapist 225 Crosslake Dr, Evansville, IN 47715-8198 2019-07-01
1346800398 Justin David Isiah King Physical Therapist 225 Crosslake Dr, Evansville, IN 47715-8198 2019-06-20
1831656313 Tri-state Orthopaedic Surgeons, Inc Occupational Therapist 225 Crosslake Dr, Evansville, IN 47715-8198 2019-02-21
1093295768 Rebecca L Thomas Nurse Practitioner 225 Crosslake Dr, Evansville, IN 47715-8198 2018-08-21
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Providers in the same zip code

NPI Name Taxonomy Address Enumeration
1114528585 Shannon Allcron Pharmacist 6770 E. Virginia St., Evansville, IN 47715 2020-11-03
1609339910 Costco Wholesale Corporation Eyewear Supplier (Equipment, not the service) 1201 Cross Pointe Place, Evansville, IN 47715 2019-04-12
1497229223 Hubert Family Dentistry LLP Dentist 6225 E Columbia St., Evansville, IN 47715 2019-01-15
1083110373 Fyi Healthcare, LLC Registered Nurse 12000 Highway 41 North, Evansville, IN 47715 2018-04-04
1962862755 New Journeys Counseling Services, LLC Community/Behavioral Health 4929 River Wind Pointe Drive, Evansville, IN 47715 2016-03-07
1558702456 Jennifer Hoelter Pharmacist 5000 E Virginia St, Walgreens District Office, Evansville, IN 47715 2013-07-09
1952649402 Courtney Ingold Music Therapist 621 E Cullen Ave, Suite 118, Evansville, IN 47715 2013-01-17
1922378041 Sherry A. Fisher Counselor 4929 Riverwind Pointe Dr Ste 102, Evansville, IN 47715 2012-01-05
1710275912 Tonja Leana Winekauf Nurse Practitioner 6211 E Waterford Blvd, Evansville Health Care Center, Evansville, IN 47715 2011-07-21
1003083437 Allcare Dental & Dentures of In PC Dentist 1031 N. Green River Rd., Suite 104, Evansville, IN 47715 2008-05-14
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Taxonomy Information

Taxonomy Code 225X00000X
Grouping Respiratory, Developmental, Rehabilitative and Restorative Service Providers
Classification Occupational Therapist

Taxonomy Definition

An occupational therapist is a person who has graduated from an entry-level occupational therapy program accredited by the Accreditation Council for Occupational Therapy Education (ACOTE) or predecessor organizations, or approved by the World Federation of Occupational Therapists (WFOT), or an equivalent international occupational therapy education program; has successfully completed a period of supervised fieldwork experience required by the occupational therapy program; has passed a nationally recognized entry-level examination for occupational therapists, and fulfills state requirements for licensure, certification, or registration. An occupational therapist provides interventions based on evaluation and which emphasize the therapeutic use of everyday life activities (i.e., occupations) with individuals or groups for the purpose of facilitating participation in roles and situations and in home, school, workplace, community and other settings. Occupational therapy services are provided for the purpose of promoting health and wellness and are provided to those who have or are at risk for developing an illness, injury, disease, disorder, condition, impairment, disability, activity limitation, or participation restriction. Occupational therapists address the physical, cognitive, psychosocial, sensory, and other aspects of occupational performance in a variety of contexts to support engagement in everyday life activities that affect health, well-being, and quality of life.
Notes: Source: The Guide to Occupational Therapy Practice, 2nd edition. Bethesda: American Occupational Therapy Association, 2007. [7/1/2008: definition changed, added source]

Providers in the same taxonomy and city

NPI Name Taxonomy Address Enumeration
1184241887 Curtis Bouchie Occupational Therapist 516 Court St Ste A, Evansville, IN 47708-1340 2020-06-29
1194357723 Gayle B Golike Occupational Therapist 5236 Vogel Rd Ste A, Evansville, IN 47715-7814 2020-02-11
1043772494 Melissa Jean Wilm Occupational Therapist 3408 Manhattan Blvd, Evansville, IN 47711-7909 2019-04-04
1730649088 Lois Sadler Occupational Therapist 851 Erie Ave Apt E, Evansville, IN 47715-4189 2019-03-22
1548775398 Madalyn Jo Schenk Occupational Therapist 811 E Baseline Rd, Evansville, IN 47725-9340 2017-12-01
1720433972 Elizabeth Bester Occupational Therapist 1800 Hercules Ave, Evansville, IN 47711-4256 2016-04-25
1952790446 Jennifer Carnahan Occupational Therapist 4900 Shamrock Dr Ste 100-102, Evansville, IN 47715-7325 2015-01-21
1730589672 Samantha Morris Occupational Therapist 9421 Hedgewood Ct, Evansville, IN 47725-7569 2014-08-28
1275951535 Amanda Patterson Occupational Therapist 6215 E Florida St, Evansville, IN 47715-2877 2014-04-03
1619228772 Kasie A Ballard Occupational Therapist 4101 Rodenberg Ave, Evansville, IN 47720-6230 2012-09-28
Find all providers in EVANSVILLE

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City EVANSVILLE
Zip Code 47715

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Dataset Information

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.

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