CHARLES TYLER THACKER DO
NPI 1902501778
Emergency Medicine in Dalton, GA

Q: What is Charles Thacker's NPI number?

The NPI number for Charles Thacker is 1902501778. It was assigned to this individual provider in the NPPES registry on April 3, 2023.

Q: What is Charles Thacker's specialty?

The primary specialty registered for this NPI is Emergency Medicine with taxonomy code 207P00000X.

Q: When was this NPI record last updated?

The NPPES record for Charles Thacker was last updated on September 3, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 months 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 03, 2023PECOS EnrolledAccepts Medicare Assignment

1200 MEMORIAL DR, DALTON, GA 30720(706) 272-6000 Get Directions Write a Review

NPPES record last updated: September 3, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Sep 3, 2026, Apr 3, 2023 (2 updates tracked since 2023).

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About Charles Tyler Thacker Do NPPES

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

CHARLES TYLER THACKER DO (NPI 1902501778) is an individual emergency medicine provider in Dalton, Georgia, licensed in Tennessee (6328) and active in the NPI registry since April 2023. He is enrolled in Medicare PECOS, is affiliated with Hamilton Medical Center, and maintains 2 additional practice locations.

NPPES Registry Identity

NPI1902501778

Entity TypeIndividualMale

Primary Taxonomy207P00000X

Provider Legal NameCHARLES TYLER THACKERCredential: DO

Location Address1200 MEMORIAL DRDalton, GA 30720-2529

Mailing Address1200 Memorial DrDalton, GA 30720-2529 · (706) 272-6000 · Fax (706) 272-6111

Phone(706) 272-6000

Sole ProprietorNo

Medical School CMSOtherGraduated 2023

Enumeration DateApril 3, 2023

Last NPPES UpdateSeptember 3, 20262 updates tracked since enumeration

NPPES CertifiedSeptember 3, 2026

✔ NPI 1902501778 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyEmergency MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207P00000X

Licenses✔ Licensed in TN · 6328✔ Licensed in GA · 109471

Definition

An emergency physician focuses on the immediate decision making and action necessary to prevent death or any further disability both in the pre-hospital setting by directing emergency medical technicians and in the emergency department. The emergency physician provides immediate recognition, evaluation, care, stabilization and disposition of a generally diversified population of adult and pediatric patients in response to acute illness and injury.

Also ListedStudent in an Organized Health Care Education/Training ProgramTaxonomy 390200000X

1200 MEMORIAL DR, Dalton, GA 30720

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Secondary Practice Locations 2

Location 1975 E 3rd StChattanooga, TN 37403-2173 · Phone (423) 778-7628

Location 216931 Rankin Ave # 100Dunlap, TN 37327-7029 · Phone (423) 949-2000

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

Charles Tyler Thacker Do 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 ID6507223781

PECOS Enrollment IDI20250912000241

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 Reassignment

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

Tennessee River Physicians, PLLC

19 mi

Emergency Medicine

1751 GUNBARREL RD
Chattanooga, TN 37421

Reassigned Medicare billing, Tennessee enrollment
183 clinicians in this Medicare group

NPI 1710424882 (423) 778-8700

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

Hospital Affiliations CMS Care Compare

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

Hamilton Medical Center

Acute Care Hospitals · Dalton, GA

2/5 CMS rating

OwnershipVoluntary non-profit - Private

CMS Certification Number110001

Location1200 Memorial DriveDalton, GA 30720 · Whitfield County

Birthing friendly

Physician Visit Costs CMS claims · ZIP area

Typical Medicare office-visit costs in the 30720 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

$83.23 typical visit price

range $53.31 – $164.04

Typical copayment $20.80 (range $13.32 – $41.01)

Most-billed visit code 99203

Established Patient

$94.84 typical visit price

range $16.68 – $133.24

Typical copayment $23.71 (range $4.17 – $33.31)

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.

Other Providers at the Same Location NPPES 20

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

MRS. JESSICA SANDERS FNP

Nurse Practitioner (Family)