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THACKER DERMATOLOGY LLC
NPI 1326347238
Dermatology in Valdosta, GA

Active since March 17, 2011CLIA 11D2022318 · Microscopy
4233 CAMELOT CROSSING, VALDOSTA, GA 31602(229) 469-4383(229) 469-4584 Get Directions Write a Review

NPPES record last updated: October 26, 2023. Verified against the NPPES registry weekly; last sync: August 09, 2026.

About Thacker Dermatology Llc NPPES

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

THACKER DERMATOLOGY LLC (NPI 1326347238) is a healthcare organization registered as a dermatology in Valdosta, Georgia and active in the NPI registry since March 2011. The organization holds a CLIA Microscopy certificate valid through October 11, 2026 and lists Betsy Perry Thacker, Owner, as its authorized official.

NPPES Registry Identity

NPI1326347238
Entity TypeOrganization
Primary Taxonomy207N00000X
Legal Business NameTHACKER DERMATOLOGY LLC
Location Address4233 CAMELOT CROSSINGValdosta, GA 31602
Mailing Address4233 Camelot CrossingValdosta, GA 31602 · (229) 469-4383 · Fax (229) 469-4584
Phone(229) 469-4383
Fax(229) 469-4584
Organization SubpartNo
Authorized OfficialBetsy Perry ThackerOwner · (229) 469-4383
Enumeration DateMarch 17, 2011
Last NPPES UpdateOctober 26, 2023
NPPES CertifiedOctober 26, 2023
✔ NPI 1326347238 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyDermatologyAllopathic & Osteopathic Physicians
Taxonomy Code207N00000X
Definition
A dermatologist is trained to diagnose and treat pediatric and adult patients with benign and malignant disorders of the skin, mouth, external genitalia, hair and nails, as well as a number of sexually transmitted diseases. The dermatologist has had additional training and experience in the diagnosis and treatment of skin cancers, melanomas, moles and other tumors of the skin, the management of contact dermatitis and other allergic and nonallergic skin disorders, and in the recognition of the skin manifestations of systemic (including internal malignancy) and infectious diseases. Dermatologists have special training in dermatopathology and in the surgical techniques used in dermatology. They also have expertise in the management of cosmetic disorders of the skin such as hair loss and scars and the skin changes associated with aging.
4233 CAMELOT CROSSING, Valdosta, GA 31602
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Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Alliant Health Plans, Inc..Insurance ›

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate for Provider-Performed Microscopy Procedures (PPMP) 11D2022318

Thacker Dermatology, LLC · Valdosta, GA
Active · expires Oct 11, 2026
CLIA Number11D2022318
Laboratory TypePhysician Office
Certificate Effective DateOctober 12, 2024
Certificate Expiration DateOctober 11, 2026
Laboratory DirectorBetsy P. Backe
Laboratory Phone(229) 469-4383
Laboratory LocationThacker Dermatology, LLC4233 Camelot Crossing, Valdosta, GA 31602
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory in which a physician, midlevel practitioner or dentist performs no tests other than the microscopy procedures. This certificate permits the laboratory to also perform waived tests.

Other Providers at the Same Location NPPES 4

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

MRS. NINA ALICE KEOWN FNP
Nurse Practitioner (Family)
4233 CAMELOT CROSSING
VALDOSTA, GA 31602
Lowndes County (229) 469-4383
DR. BETSY PERRY BACKE M.D.
Dermatology
4233 CAMELOT CROSSING
VALDOSTA, GA 31602
Lowndes County (229) 469-4383
CANDIS SAUNDERS DAVIS RN
Nurse Practitioner (Family)
4233 CAMELOT CROSSING
VALDOSTA, GA 31602
Lowndes County (229) 469-4383
ABBEY WALKER VANDERMEID NP
Nurse Practitioner (Adult Health)
4233 CAMELOT CROSSING
VALDOSTA, GA 31602
Lowndes County (229) 469-4383

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 Thacker Dermatology LLC's NPI number?

The NPI number for Thacker Dermatology LLC is 1326347238. It was assigned to this organization in the NPPES registry on March 17, 2011.

Where is Thacker Dermatology LLC located?

Thacker Dermatology LLC is located at 4233 Camelot Crossing, Valdosta, GA 31602. The listed phone number is (229) 469-4383.

What is Thacker Dermatology LLC's specialty?

The primary specialty registered for this NPI is Dermatology with taxonomy code 207N00000X.

Does Thacker Dermatology LLC hold a CLIA laboratory certificate?

Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 11D2022318) is associated with this NPI, valid through October 11, 2026. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Thacker Dermatology LLC accept?

Health plans from Alliant Health Plans, Inc. list Thacker Dermatology LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Thacker Dermatology LLC was last updated on October 26, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 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.