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DR. MITCHEL L. THACKER D.C.
NPI 1710059498
Chiropractor in Conyers, GA

Active since November 15, 2006Accepts Medicare Assignment
1815 HIGHWAY 138 SE, SUITE 600, CONYERS, GA 30013(770) 860-8333(770) 860-8833 Get Directions Write a Review

NPPES record last updated: July 8, 2007. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About Dr. Mitchel L. Thacker D.c. NPPES

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

DR. MITCHEL L. THACKER D.C. (NPI 1710059498) is an individual chiropractor in Conyers, Georgia, licensed in Georgia (CHIR002342) and active in the NPI registry since November 2006. He is a graduate of Life Chiropractic College (1983).

NPPES Registry Identity

NPI1710059498
Entity TypeIndividualMale
Primary Taxonomy111N00000X
Provider Legal NameDR. MITCHEL L. THACKERCredential: D.C.
Location Address1815 HIGHWAY 138 SE, SUITE 600Conyers, GA 30013-2079
Mailing Address2575 Abbey Ridge Rd SwConyers, GA 30094-3459 · (770) 860-8333 · Fax (770) 860-8833
Phone(770) 860-8333
Fax(770) 860-8833
Sole ProprietorNo
Medical School CMSLife Chiropractic CollegeGraduated 1983
Enumeration DateNovember 15, 2006
Last NPPES UpdateJuly 8, 2007
✔ NPI 1710059498 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyChiropractorChiropractic Providers
Taxonomy Code111N00000X
License✔ Licensed in GA · CHIR002342
Definition
A provider qualified by a Doctor of Chiropractic (D.C.), licensed by the State and who practices chiropractic medicine -that discipline within the healing arts which deals with the nervous system and its relationship to the spinal column and its interrelationship with other body systems.
1815 HIGHWAY 138 SE, Conyers, GA 30013
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Other Identifiers 2

Medicare ID-Type Unspecified35ZCCPWGA · Medicare Provider Number
Medicare UPINU22579GA

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

Dr. Mitchel L. Thacker D.c. 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 ID5496859399
PECOS Enrollment IDI20130624000549

Medicare Billing Reassignment

Medicare enrollment records show Mitchel Thacker reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Thacker Chiropractic Clinic, LLC
Same address
Chiropractor
1815 HIGHWAY 138 SE, SUITE 600
Conyers, GA 30013
  • Reassigned Medicare billing, Georgia enrollment
  • 2 clinicians in this Medicare group
NPI 1255489712 (770) 860-8333

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

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.

Chiropractic manipulative treatment, 1-2 spinal regions 98940
Chiropractic manipulative treatment focuses on adjusting your spine to improve your body's physical function. In this service, a chiropractor applies controlled force to 1-2 spinal regions. This helps to restore mobility and alleviate discomfort in those areas.
164 services35 patients

Other Providers at the Same Location NPPES 3

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

THACKER CHIROPRACTIC CLINIC, LLC
Chiropractor
1815 HIGHWAY 138 SE, SUITE 600
CONYERS, GA 30013
Rockdale County (770) 860-8333
DR. STEVEN MARK THACKER DC
Chiropractor
1815 HIGHWAY 138 SE, SUITE 600
CONYERS, GA 30013
Rockdale County (770) 860-8333
DR. ADRIANNE J ROSS D.P.M.
Podiatrist (Foot & Ankle Surgery)
1815 HIGHWAY 138 SE, SUITE 600
CONYERS, GA 30013
Rockdale County (770) 922-8922

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 Mitchel Thacker's NPI number?

The NPI number for Mitchel Thacker is 1710059498. It was assigned to this individual provider in the NPPES registry on November 15, 2006.

Where is Mitchel Thacker located?

Mitchel Thacker practices at 1815 Highway 138 SE Suite 600, Conyers, GA 30013. The listed phone number is (770) 860-8333.

What is Mitchel Thacker's specialty?

The primary specialty registered for this NPI is Chiropractor with taxonomy code 111N00000X.

Is Mitchel Thacker enrolled in Medicare?

Yes. Mitchel 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 organization bills Medicare for Mitchel Thacker's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Mitchel Thacker reassigns Medicare benefits to Thacker Chiropractic Clinic, LLC (Conyers, GA). The 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 Mitchel Thacker's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

When was this NPI record last updated?

The NPPES record for Mitchel Thacker was last updated on July 8, 2007. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 19 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.