CHERYL NICOLE THACKER (AGPCNP-BC) – Nurse Practitioner, NPI 1336972264

CHERYL NICOLE THACKER (AGPCNP-BC) is a healthcare provider. based in Jacksonville, Florida. specializing in NURSE PRACTITIONER. They hold the professional credentials AGPCNP-BC. They hold a License No. 11034425 (FL). The NPI Number for CHERYL NICOLE THACKER (AGPCNP-BC) is 1336972264

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
CHERYL NICOLE THACKER (AGPCNP-BC)
NPI
1336972264
Phone
(904) 652-0652
Address
4866 BIG ISLAND DR UNIT 5
Enumeration Date
26 August 2024
Last Update Date
26 August 2024

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9043301024
Graduation Year
2024 (2 years ago)
PAC ID
6002337656
Group Practice PAC ID
7416280425
Professional Enrollment ID
I20250311003245
Address ID
FL322166286JA6817XPKWY301
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:1State licenses:1Digital endpointsOther names

24,232 NURSE PRACTITIONER in FL

Provider Addresses for CHERYL NICOLE THACKER (AGPCNP-BC)

  • 4866 BIG ISLAND DR UNIT 5

    JACKSONVILLE, FL 322465301

    Phone: (904) 652-0652

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

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Open Payments (CMS)

CMS reports 1 Open Payments records for all available years, with a total value of $19.

Total Amount is formed as General ($19) + Research ($0) + Ownership ($0) = $19.

Last reported payment date: 2024-12-16 • Largest payer in this snapshot: Gilead Sciences, Inc. ($19).

Total Amount

$19

General + Research + Ownership

Payments

1

Total payment records

General Amount

$19

General payments

Research Amount

$0

Research funding

Ownership Amount

$0

Ownership interests

Ownership Count

0

Ownership records

Last Payment Date

2024-12-16

Latest reported date

Top Companies

Largest payers in this snapshot

CompanyAmount
Gilead Sciences, Inc.$19
View all Open Payments →|Open Payments Risk Radar →

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2025-03-11

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
I20250311003245INurse PractitionerFLTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 32246)

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Group practice members

Group practice members are other physicians who share the same Group Practice PAC ID with this doctor. When doctors form a group practice and register in PECOS as a single entity, they receive a shared identification number. This table lists all providers in the same group practice.
PAC ID: 7416280425View full group profile
NameSpecialtyState
Nurse PractitionerFL
Nurse PractitionerIL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nephrology, Internal Medicine, Internal Medicine, NephrologyGA
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL
Nurse PractitionerFL

Reviews

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Frequently asked questions

What is CHERYL NICOLE THACKER (AGPCNP-BC)'s NPI number?
CHERYL NICOLE THACKER (AGPCNP-BC)'s NPI is 1336972264 — the number used across U.S. healthcare to identify this provider.
Would CHERYL NICOLE THACKER (AGPCNP-BC) appear as active to a payer?
You can treat CHERYL NICOLE THACKER (AGPCNP-BC) as active for directory purposes; confirm clinical privileges separately.
What area of care is associated with CHERYL NICOLE THACKER (AGPCNP-BC)?
CHERYL NICOLE THACKER (AGPCNP-BC)'s record emphasizes Nurse Practitioner. Clinical services aligned with this taxonomy classification.
What locale is associated with CHERYL NICOLE THACKER (AGPCNP-BC)?
Directory geography for CHERYL NICOLE THACKER (AGPCNP-BC) centers on Jacksonville, Florida.
What does 2 location(s) imply?
2 practice locations appear in the available data.

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