Carl Edward Thornblade, MD

Primary specialty

Allergy & Immunology PhysicianTaxonomy code 207K00000X

License

11594 Issued in MT

Practice address

2801 Great Northern Loop
Suite 101
Missoula, MT 59808-1745

Phone

(406) 728-6472

Fax

(406) 728-9175

NPI assigned

Sep 28, 2006

Sex

Male

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in MT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: Yes

Green means eligible to order or refer.

Enrollment records 1

Specialty

Allergy/ImmunologyAlso: Internal Medicine

Education

University of Pittsburgh School of Medicine, 1997

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Carl Thornblade, MD, PLLCGroup PAC ID 3375613342, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Carl Thornblade, MD, PLLC

  • Allergy & Immunology Physician
  • Missoula, MT
  • NPI 1750557690
  Medicare reassignment Care Compare group NPD Authorized official
• Frances Mahon Deaconess Hospital

  • Critical Access Hospital
  • Glasgow, MT
  • NPI 1689685323
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1159401600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1438300800000",
    "number": "1073605200",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2801 GREAT NORTHERN LOOP",
            "address_2": "SUITE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081745",
            "telephone_number": "406-728-6472",
            "fax_number": "406-728-9175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2801 GREAT NORTHERN LOOP",
            "address_2": "SUITE 101",
            "city": "MISSOULA",
            "state": "MT",
            "postal_code": "598081745",
            "telephone_number": "406-728-6472",
            "fax_number": "406-728-9175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBLADE",
        "first_name": "CARL",
        "middle_name": "EDWARD",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-09-28",
        "last_updated": "2015-07-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MD",
            "license": "D0062345",
            "primary": false
        },
        {
            "code": "207K00000X",
            "taxonomy_group": "",
            "desc": "Allergy & Immunology",
            "state": "MT",
            "license": "11594",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Sally Thompson, M.S. SLP
• Steven J Thompson, DO
• Susan Mary Thompson, PT
• Genine Marie Thormahlen, PHARM. D., AE-C
• Paul T Thormahlen, MSPT, ATC
• Aric Thorne-Thomsen, PT
• Ragna Thorne-Thomsen, PT
• Carolyn Louise Thornton, R.N.
• Naomi S Thornton, L.C.S.W.
• Christi L Thorsell

• Allergy & Immunology Physician in Missoula, MT
• Providers in Missoula, MT by specialty
• Allergy & Immunology Physician in Montana

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.