KELSEY MARIE THACKER – Nurse Practitioner, NPI 1245765296
Nurse Practitioner
Main info
Doctor Profile
Profile Insights
NPPES metrics only — not quality of care.
11,632 NURSE PRACTITIONER in IL
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Provider Addresses for KELSEY MARIE THACKER
104, Ashland Avenue, Mount Zion, Macon County, Illinois, 62549, United States
MT. ZION, IL 62549
Phone: (217) 864-2665
Fax: (217) 864-8042
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 2 Open Payments records for all available years, with a total value of $42.
Total Amount is formed as General ($42) + Research ($0) + Ownership ($0) = $42.
Last reported payment date: 2024-07-18 • Largest payer in this snapshot: Organogenesis Inc. ($22).
Total Amount
$42
General + Research + Ownership
Payments
2
Total payment records
General Amount
$42
General payments
Research Amount
$0
Research funding
Ownership Amount
$0
Ownership interests
Ownership Count
0
Ownership records
Last Payment Date
2024-07-18
Latest reported date
Top Companies
Largest payers in this snapshot
| Company | Amount |
|---|---|
| Organogenesis Inc. | $22 |
| Novo Nordisk Inc | $20 |
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: 2017-05-17
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
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| I20170517002865 | I | Nurse Practitioner | IL | TBD |
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.
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.
Top Medicare procedures (2023) · refreshed 2026-05-27
| HCPCS | Description | Services | Beneficiaries | Medicare allowed |
|---|---|---|---|---|
| J3301 | Injection, triamcinolone acetonide, not otherwise specified, 10 mg | 491 | 75 | $0 |
| 99214 | Established patient office or other outpatient visit, 30-39 minutes | 104 | 87 | $0 |
| 20610 | Aspiration and/or injection of fluid from large joint | 93 | 74 | $0 |
| 99213 | Established patient office or other outpatient visit, 20-29 minutes | 51 | 47 | $0 |
| 73564 | X-ray of knee, 4 or more views | 51 | 51 | $0 |
Insurance plans in this area (ZIP 62549)
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Group practice members
| Name | Specialty | State |
|---|---|---|
| Physical Therapist In Private Practice | IL | |
| Orthopedic Surgery, Plastic And Reconstructive Surgery | IL | |
| - | IL | |
| Physical Therapist In Private Practice | IL | |
| Nurse Practitioner | IL | |
| Orthopedic Surgery | IL | |
| P O D I A T R Y | IL | |
| Nurse Practitioner | IL | |
| Nurse Practitioner | IL |
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