Individual Healthcare Provider
Clifford Lee Thacker, MD
Provider's NPPES record last updated: July 21, 2022
Overview
- Entity Type
- Individual Healthcare Provider
- NPI
- 1396731857
- Primary Specialty
- Family Medicine — Addiction Medicine
- Practice Location
- Fort Myers, Florida
- Sole Proprietor
- No
Federal Screening
NPISignal checked this NPI against federal exclusion sources. Results below are based on the NPI number itself — an identifier match, not a name match.
List of Excluded Individuals/Entities (LEIE)
HHS Office of Inspector General
No potential match was identified in NPISignal's indexed List of Excluded Individuals/Entities (LEIE) records as of 2026-09-10.
- Source data
- September 10, 2026
- Records indexed
- 84,001
- Screened
- Sep 18, 2026, 1:04 PM UTC
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
SAM.gov Exclusions
U.S. General Services Administration
SAM.gov Exclusions was not checked.
SAM.gov screening is not configured on this deployment. No SAM check has been performed.
- Screened
- Not checked
This is an NPI-based check only. NPISignal does not publish name-based exclusion matches on a provider profile. A shared or similar name is a lead that requires human review, not an identification, and this page is not the place to make one. Run a name-based screening below to see potential matches with the reasons for each.
This reflects only the records NPISignal currently holds and the identity information supplied. It is not a verification of eligibility, licensure, or compliance. Verify decisions that matter against the authoritative source.
Searches OIG LEIE and SAM.gov by name and reviews every potential match.
Specialties & Taxonomies
- Primary
Family Medicine
Addiction Medicine
Allopathic & Osteopathic Physicians
A family medicine physician who specializes in the diagnosis and treatment of addictions.
Taxonomy code 207QA0401X Family Medicine
Allopathic & Osteopathic Physicians
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
Taxonomy code 207Q00000XObstetrics & Gynecology
Allopathic & Osteopathic Physicians
An obstetrician/gynecologist possesses special knowledge, skills and professional capability in the medical and surgical care of the female reproductive system and associated disorders. This physician serves as a consultant to other physicians and as a primary physician for women.
Taxonomy code 207V00000XPsychiatry & Neurology
Psychiatry
Allopathic & Osteopathic Physicians
A Psychiatrist specializes in the prevention, diagnosis, and treatment of mental disorders, emotional disorders, psychotic disorders, mood disorders, anxiety disorders, substance-related disorders, sexual and gender identity disorders and adjustment disorders. Biologic, psychological, and social components of illnesses are explored and understood in treatment of the whole person. Tools used may include diagnostic laboratory tests, prescribed medications, evaluation and treatment of psychological and interpersonal problems with individuals and families, and intervention for coping with stress, crises, and other problems.
Taxonomy code 2084P0800X
Provider-Reported License Information
- Family Medicine (Florida)
- ME70754
- Family Medicine (Florida)
- ME70754
- Obstetrics & Gynecology (Florida)
- ME0070754
- Psychiatry & Neurology (Florida)
- ME70754
Practice Locations
Practice Location
12550 New Brittany Blvd Ste 201
Fort Myers, Florida 33907
Phone: (239) 343-9190
Additional Practice Location
9818 Old Hyde Park Pl
Bradenton, Florida 34202-4091
Phone: (941) 556-9337
Additional Practice Location
12550 New Brittany Blvd Ste 201
Fort Myers, Florida 33907
Phone: (239) 343-9190
Fax: (239) 343-9193
Record Information
- Enumeration Date
- September 21, 2005
- Provider's NPPES Record Last Updated
- July 21, 2022
- Certification Date
- October 27, 2020
- NPISignal NPPES Dataset
- August 2026
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