KELSEY MARIE THACKER
NPI 1245765296
Nurse Practitioner in Mt Zion, IL

Q: What is Kelsey Thacker's NPI number?

The NPI number for Kelsey Thacker is 1245765296. It was assigned to this individual provider in the NPPES registry on April 27, 2017.

Q: What is Kelsey Thacker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Q: When was this NPI record last updated?

The NPPES record for Kelsey Thacker was last updated on April 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 27, 2017PECOS EnrolledAccepts Medicare Assignment

95.01/100

CMS Quality Rating

104 E ASHLAND AVE, MT ZION, IL 62549(217) 864-2665(217) 864-8042 Get Directions Write a Review

NPPES record last updated: April 27, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

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About Kelsey Marie Thacker NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KELSEY MARIE THACKER (NPI 1245765296) is an individual nurse practitioner in Mt Zion, Illinois, licensed in Illinois (209015926) and active in the NPI registry since April 2017. She is enrolled in Medicare PECOS, is affiliated with St Anthonys Memorial Hospital, and is a graduate of Other (2016).

NPPES Registry Identity

NPI1245765296

Entity TypeIndividualFemale

Primary Taxonomy363L00000X

Provider Legal NameKELSEY MARIE THACKER

Location Address104 E ASHLAND AVEMt Zion, IL 62549-1271

Mailing Address104 Ashland AvenueMt. Zion, IL 62549 · (217) 864-2665 · Fax (217) 864-8042

Phone(217) 864-2665

Fax(217) 864-8042

Sole ProprietorNo

Medical School CMSOtherGraduated 2016

Enumeration DateApril 27, 2017

✔ NPI 1245765296 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse PractitionerPhysician Assistants & Advanced Practice Nursing Providers

Taxonomy Code363L00000X

License✔ Licensed in IL · 209015926

Definition

(1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.

104 E ASHLAND AVE, Mt Zion, IL 62549

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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare and accepts Medicare assignment

Kelsey Marie Thacker is registered in PECOS and agrees to accept the Medicare-approved amount as full payment. Medicare patients are not billed beyond the standard deductible and coinsurance.

PECOS PAC ID6002183381

PECOS Enrollment IDI20170517002865

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment✔ Home Health Agency✔ Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignments

Medicare enrollment records show Kelsey Thacker reassigns Medicare billing to 3 organizations. Each organization bills Medicare for the services this provider delivers there; the nearest is listed first.

Decatur Orthopedic Center, LLC

Same address

Orthopaedic Surgery

104 ASHLAND AVE.
Mt. Zion, IL 62549

Reassigned Medicare billing, Illinois enrollment
16 clinicians in this Medicare group

NPI 1336586114 (217) 864-2665

Pana Community Hospital Association

21 mi

Family Medicine

118 N WALNUT ST
Assumption, IL 62510

Reassigned Medicare billing, Illinois enrollment
Also billed through NPI 1942326970 (Illinois)
98 clinicians in this Medicare group

NPI 1487843959 (217) 226-3133

Kirby Medical Center

25 mi

Family Medicine

1000 MEDICAL CENTER DR
Monticello, IL 61856

Reassigned Medicare billing, Illinois enrollment
171 clinicians in this Medicare group

NPI 1386635373 (217) 762-2115

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Areas of Expertise CMS Part B claims 13

Services this provider delivered to Medicare fee-for-service patients, from the CMS Medicare utilization data. Higher counts generally reflect more experience with a service; care delivered outside Medicare is not included.

Injection, triamcinolone acetonide, not otherwise specified, 10 mg J3301

Triamcinolone acetonide is a medication used to reduce inflammation in the body. It's given as a 10 mg injection for conditions like allergies, arthritis, or skin problems. The injection helps to decrease swelling, redness, and itching.

893 services132 patients

Established patient office or other outpatient visit with moderate level of decision making, if using time, 30 minutes or more 99214

This is a routine check-up for patients who have previously visited our clinic. It involves a comprehensive review of your health and any ongoing treatments. The consultation lasts between 30-39 minutes, allowing enough time to discuss any concerns.

202 services152 patients

Aspiration and/or injection of fluid from large joint 20610

This procedure involves using a needle to remove (aspiration) or introduce (injection) fluid into a large joint like the knee or hip. It can help diagnose conditions, relieve discomfort, or deliver medication directly to the joint.

170 services130 patients

Established patient office or other outpatient visit with low level od decision making, if using time, 20 minutes or more 99213

This is a routine visit for patients who have already been seen by the healthcare provider. During this approximately 20-29 minute appointment, your health status will be evaluated and any necessary treatments or tests will be discussed. It's a chance to address any health concerns you may have.

98 services86 patients

X-ray of knee, 4 or more views 73564

An X-ray of the knee, 4 or more views, is a non-invasive imaging test. It involves capturing multiple images of your knee from different angles. This helps in diagnosing conditions such as fractures, arthritis, or infections. The procedure is quick and painless.

94 services88 patients

X-ray of shoulder, minimum of 2 views 73030

An X-ray of the shoulder, with a minimum of 2 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of your shoulder bones. This helps in diagnosing conditions like fractures, arthritis, or other abnormalities. The procedure is quick and painless.

69 services62 patients

X-ray of hip, 2-3 views 73502

An X-ray of the hip with 2-3 views is a non-invasive imaging test. It uses a small amount of radiation to produce pictures of the hip joint. These images help in diagnosing conditions like fractures, arthritis, or other abnormalities. The process is quick and painless.

57 services54 patients

New patient office or other outpatient visit with moderate level of medical decision making, if using time, 45 minutes or more 99204

This is a first-time office or outpatient visit lasting between 45-59 minutes. The healthcare provider evaluates your health, discusses your medical history, and may suggest further tests or treatments. It's an opportunity to ask questions and understand your health better.

57 services57 patients

X-ray of knee, 3 views 73562

An X-ray of the knee, 3 views, is a non-invasive imaging test. It uses a small amount of radiation to produce images of the knee from three different angles. This helps medical professionals to diagnose and monitor conditions like arthritis, fractures, or infections. The process is quick and painless.

50 services45 patients

Replacement of knee joint, both sides of knee 27447

A bilateral knee joint replacement is a procedure where the damaged parts of both your knee joints are replaced with artificial parts. It aims to relieve pain and improve mobility. The process involves a surgical operation under anesthesia.

44 services43 patients

Replacement of thigh bone and hip joint with prosthesis 27130

This procedure, known as hip arthroplasty, involves replacing your damaged thigh bone and hip joint with artificial parts, called a prosthesis. It helps relieve pain, improve mobility, and enhance your quality of life.

21 services20 patients

New patient office or other outpatient visit with low level of medical decision making, if using time, 30 minutes or more 99203

This service involves an initial office or outpatient visit for a new patient. The healthcare professional will spend 30-44 minutes understanding your health history, current issues, and discussing possible treatment plans. It's a comprehensive evaluation to start your healthcare journey.

18 services18 patients

Prosthetic repair of shoulder joint, total shoulder 23472

Total shoulder prosthetic repair is a surgical procedure to replace a damaged shoulder joint with artificial components. It aims to relieve pain and restore mobility. The procedure involves replacing the ball (humeral head) and socket (glenoid) of the shoulder joint.

14 services14 patients

Hospital Affiliations CMS Care Compare 3

Hospitals where this provider delivers care, identified from recent Medicare claims and place-of-service records.

St Anthonys Memorial Hospital

Acute Care Hospitals · Effingham, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Church

CMS Certification Number140032

Location503 N Maple StreetEffingham, IL 62401 · Effingham County

Emergency services Birthing friendly

Decatur Memorial Hospital

Acute Care Hospitals · Decatur, IL

3/5 CMS rating

OwnershipVoluntary non-profit - Other

CMS Certification Number140135

Location2300 North Edward StreetDecatur, IL 62526 · Macon County

Emergency services Birthing friendly

St Marys Hospital

Acute Care Hospitals · Decatur, IL

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number140166

Location1800 E Lake Shore DrDecatur, IL 62521 · Macon County

Emergency services Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 62549 ZIP code area, from fee-for-service claims. These are area statistics, not this provider’s prices; actual charges vary by service and coverage.

New Patient

$85.71 typical visit price

range $54.80 – $168.44

Typical copayment $21.42 (range $13.70 – $42.11)

Most-billed visit code 99203

Established Patient

$97.25 typical visit price

range $17.16 – $136.56

Typical copayment $24.31 (range $4.29 – $34.14)

Most-billed visit code 99214

Amounts reflect what Medicare beneficiaries in this ZIP area are typically charged for office visits. Patients with other coverage should check their individual plans.

Medicare Quality Performance CMS QPP · MIPS

Performance in the CMS Quality Payment Program: the MIPS final score across four weighted categories, and the individual quality measures reported to Medicare.

95.01/100

MIPS Final ScoreMerit-based Incentive Payment System · CMS Quality Payment Program

Scored through an Alternative Payment Model

Quality

80.02

Promoting Interoperability

100

Improvement Activities

Other Providers at the Same Location NPPES 12

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MADELINE FAITH MACKIN PT, DPT

Physical Therapist

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

STEPHANIE JO MCGEORGE BSN RN CNOR RNFA

Registered Nurse (Orthopedic)

104 E ASHLAND AVE
MOUNT ZION, IL 62549

Macon County (217) 864-2665

SULLIVAN & SAMS MEDICAL, LLC

Durable Medical Equipment & Medical Supplies

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-8364

DECATUR ORTHOPEDIC CENTER, LLC

Durable Medical Equipment & Medical Supplies

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

DANA YOUNG BSN, RN, CNOR, RNFA

Registered Nurse (Registered Nurse First Assistant)

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

MEGAN MUSICK M.P.T.

Physical Therapist

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

MADDISON RAE MAXEDON APRN

Nurse Practitioner

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

DECATUR ORTHOPEDIC CENTER, LLC

Non-Pharmacy Dispensing Site

104 E ASHLAND AVE
MT ZION, IL 62549

Macon County (217) 864-2665

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kelsey Thacker's NPI number?

The NPI number for Kelsey Thacker is 1245765296. It was assigned to this individual provider in the NPPES registry on April 27, 2017.

Where is Kelsey Thacker located?

Kelsey Thacker practices at 104 E Ashland Ave, Mt Zion, IL 62549. The listed phone number is (217) 864-2665.

What is Kelsey Thacker's specialty?

The primary specialty registered for this NPI is Nurse Practitioner with taxonomy code 363L00000X.

Is Kelsey Thacker enrolled in Medicare?

Yes. Kelsey Thacker is registered in the Medicare PECOS system and accepts Medicare assignment, which means accepting the Medicare-approved amount as payment in full for covered services.

Which organizations bill Medicare for Kelsey Thacker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Kelsey Thacker reassigns Medicare benefits to 3 organizations: Decatur Orthopedic Center, LLC (Mt. Zion, IL), Pana Community Hospital Association (Assumption, IL) and Kirby Medical Center (Monticello, IL). Each reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Kelsey Thacker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

Is Kelsey Thacker affiliated with any hospitals?

According to CMS data, Kelsey Thacker is affiliated with St Anthonys Memorial Hospital, Decatur Memorial Hospital and St Marys Hospital.

When was this NPI record last updated?

The NPPES record for Kelsey Thacker was last updated on April 27, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.