COURTNEY BRYCE THAYER – Family Nurse Practitioner, NPI 1417767302

COURTNEY BRYCE THAYER is a healthcare provider. based in Burkburnett, Texas. specializing in NURSE PRACTITIONER. They hold a License No. 1185946 (TX). The NPI Number for COURTNEY BRYCE THAYER is 1417767302

Main info

Female
2 Years Of Experience
Accepts Medicare Assignment
Name
COURTNEY BRYCE THAYER
NPI
1417767302
Phone
(940) 224-3610
Address
602 MIMOSA ST
Enumeration Date
13 January 2025
Last Update Date
13 January 2025

Doctor Profile

Medical School Name
OTHER
Secondary Phone
9402829216
Graduation Year
2024 (2 years ago)
PAC ID
6204358989
Group Practice PAC ID
4284074329
Professional Enrollment ID
I20250323000032
Address ID
TX763014405WI1518XSTXX300
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience26
Completeness75
Years active:1State licenses:1Digital endpointsOther names

22,204 NURSE PRACTITIONER in TX

Provider Addresses for COURTNEY BRYCE THAYER

  • 602 MIMOSA ST

    BURKBURNETT, TX 763542350

    Phone: (940) 224-3610

    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)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

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: 2025-03-23

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
I20250323000032INurse PractitionerTXTBD

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 76354)

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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: 4284074329View full group profile
NameSpecialtyState
Physician AssistantTX
Nurse PractitionerTX
Nurse PractitionerTX

Reviews

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Frequently asked questions

Can I verify COURTNEY BRYCE THAYER with an NPI only?
You can start verification with NPI 1417767302 for COURTNEY BRYCE THAYER, then check state licensing separately.
Can I rely on COURTNEY BRYCE THAYER being an active provider?
As of the registry snapshot, COURTNEY BRYCE THAYER is marked active.
What taxonomy line describes COURTNEY BRYCE THAYER?
For research purposes, treat COURTNEY BRYCE THAYER as Family Nurse Practitioner in this dataset. Clinical services aligned with this taxonomy classification.
What address line appears for COURTNEY BRYCE THAYER?
COURTNEY BRYCE THAYER's geographic hint is Burkburnett, Texas in our summary view.
Why does COURTNEY BRYCE THAYER have multiple addresses?
2 practice locations appear in the available data. Multiple addresses are common for hospital privileges, telehealth, or multi-site groups.

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