Carl R Thornfeldt, MD

Primary specialty

Dermatology PhysicianTaxonomy code 207N00000X

License

M7442 Issued in ID

Practice address

811 NW 12TH St
Fruitland, ID 83619-2268

Phone

(208) 452-7450

Fax

(208) 452-7550

NPI assigned

Jun 4, 2006

Last updated

Mar 25, 2015By the provider in NPPES

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Interoperability endpoints

• Direct secure messaging: carl.thornfeldt.p1@direct.ctdermpc.nextgenshare.com

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

• CT Derm PC

  • Dermatology Physician
  • Fruitland, ID
  • NPI 1902843485
  Authorized official Same address or phone

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

{
    "created_epoch": "1149379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1427241600000",
    "number": "1083653489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 NW 12TH ST",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192268",
            "telephone_number": "208-452-7450",
            "fax_number": "208-452-7550"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "811 NW 12TH ST",
            "city": "FRUITLAND",
            "state": "ID",
            "postal_code": "836192268",
            "telephone_number": "208-452-7450",
            "fax_number": "208-452-7550"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNFELDT",
        "first_name": "CARL",
        "middle_name": "R",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-06-04",
        "last_updated": "2015-03-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207N00000X",
            "taxonomy_group": "",
            "desc": "Dermatology",
            "state": "ID",
            "license": "M7442",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cody D. Stephens, M.P.T.
• Brady Lynn Stewart, DPM
• Timmothy Stewart
• The Gardens Chiropractic
• Therapy Connection
• Bryant Adams Timmons, DDS
• J. Alan Timmons, D.D.S.
• Olivia Toll
• Total Renal Care, Inc. (Fruitland Dialysis)
• Total Wellness Chiropractic and Holistic Care LLC

• Dermatology Physician in Fruitland, ID
• Providers in Fruitland, ID by specialty
• Dermatology Physician in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 25, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.