Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jamie Thacker

Individual provider Family Nurse Practitioner · NPI 1548998131

Jamie Thacker is a Nurse Practitioner in Mishawaka, Indiana. Qualified in 2022, 4 years ago. Practices with Beacon Medical Group Inc, a 574-clinician group and accepts Medicare assignment. Licensed in Indiana.

Years since qualifying
4
Licensed in
IN
In the registry since
2022
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Practice location Address checks out

4630 Vistula Rd
Mishawaka, IN 46544-4000
Phone: (574) 647-1900
Fax: (574) 647-7289
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Nurse Practitioner (primary) Taxonomy 363LF0000X · Licence 28202077A (IN)

Record details

NPI number1548998131
Entity typeIndividual (Type 1)
GenderFemale
Sole proprietorNo
NPI enumeratedAugust 11, 2022
Last updated in NPPESNovember 30, 2023
Certification dateNovember 30, 2023
Mailing address3245 Health Dr Ste 100, Granger, IN 46530-1380

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyNURSE PRACTITIONER
Medical schoolOTHER
Graduated 2022 (4 years in practice)
Group practice Beacon Medical Group Inc — 574 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount

Other providers in Mishawaka