CLIFFORD LEE THACKER MD
NPI 1396731857
Family Medicine - Addiction Medicine in Fort Myers, FL
NPI Status: Active since September 21, 2005
Contact Information
12550 NEW BRITTANY BLVD STE 201
FORT MYERS, FL
ZIP 33907
Phone: (239) 343-9190
Fax: (239) 343-9193
- Individual
- Male
- Family Medicine
- Addiction Medicine
About CLIFFORD THACKER
This page provides the complete NPI Profile along with additional information for Clifford Thacker, a provider established in Fort Myers, Florida with a medical specialization in Family Medicine, focusing in addiction medicine . The healthcare provider is registered in the NPI registry with number 1396731857 assigned on September 2005. The practitioner's primary taxonomy code is 207QA0401X with license number ME70754 (FL). The provider is registered as an individual and his NPI record was last updated 4 years ago.
- NPI
- 1396731857
- Provider Name
- CLIFFORD LEE THACKER MD
- Gender
- Male
- Entity Type
- Individual
- Location Address
- 12550 NEW BRITTANY BLVD STE 201 FORT MYERS, FL 33907
- Location Phone
- (239) 343-9190
- Location Fax
- (239) 343-9193
- Mailing Address
- PO BOX 2147 FORT MYERS, FL 33902
- Mailing Phone
- (239) 343-9190
- Mailing Fax
- (239) 343-9193
- Is Sole Proprietor?
- No
- Enumeration Date
- 09-21-2005
- Last Update Date
- 07-21-2022
- Code Navigator
Location Map
Secondary Locations
- 9818 Old Hyde Park Pl
Bradenton, FL 34202
(941) 556-9337 - 12550 New Brittany Blvd Ste 201
Fort Myers, FL 33907
(239) 343-9190
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Addiction Medicine
- Taxonomy Code
- 207QA0401X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- ME70754
- License State
- FL
- Taxonomy Description
- A family medicine physician who specializes in the diagnosis and treatment of addictions.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | ME70754 (FL) |
| 2 | 207V00000X | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology | ME0070754 (FL) |
| 3 | 2084P0800X | Allopathic & Osteopathic Physicians | Psychiatry & Neurology | ME70754 (FL) |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
Additional Identifiers
The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.
| Identifier | Type / Code | Identifier State | Identifier Issuer |
|---|---|---|---|
| 101588900 | MEDICAID (05) | FL |
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1396731857, we treat the final digit (7) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 63. The final step is to find the difference between that total and the next multiple of ten (70 - 63 = 7).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 63 is 70. The difference is the calculated check digit.
Other Providers at the Same Location
The following 3 providers are registered at the same or a nearby location.
FORT MYERS, FL 33907
FORT MYERS, FL 33907
FORT MYERS, FL 33907
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1396731857, enumerated as an "individual" on September 21, 2005.
The provider is located at 12550 NEW BRITTANY BLVD STE 201 FORT MYERS, FL 33907 and the phone number is (239) 343-9190.
Family Medicine with taxonomy code 207QA0401X and a focus in Addiction Medicine.
The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.
