Individual provider Active NPI

Nikki Latoya Thornton, D.C.

  • Chiropractor
  • Georgetown, TX
National Provider Identifier
1083942528
Registry record updated Aug 3, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
12015 Issued in TX
Practice address
3007 Dawn Dr Ste 101
Georgetown, TX 78628-2864
Phone
(512) 863-7000
Fax
(512) 231-1087
NPI assigned
Nov 20, 2009
Last updated
Aug 3, 2022By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 3, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 31459 CA
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 12015 TX Primary

Addresses

Primary practice location

3007 Dawn Dr Ste 101
Georgetown, TX 78628-2864

Mailing address

3007 Dawn Dr Ste 101
Georgetown, TX 78628-2864
Phone (512) 863-7000

Other practice location 1

4210 Spicewood Springs Rd Ste 205
Austin, TX 78759-8654
Phone (512) 346-5567

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220815002839 TX Practitioner - Chiropractic 1153457205

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Other, 2009
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

3008 Dawn Dr
Suite 202
Georgetown, TX 78628-2822
Phone (512) 863-7000

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
12015TXMDProfessional Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
American Chiropractic Clinic - Austin LLC Chiropractor PastSince Mar 28, 2016 Accepting new patients
Ricky B. Radtke Chiropractor Past Accepting new patients

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1258675200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659484800000",
    "number": "1083942528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3007 DAWN DR STE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282864",
            "telephone_number": "512-863-7000",
            "fax_number": "512-231-1087"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3007 DAWN DR STE 101",
            "city": "GEORGETOWN",
            "state": "TX",
            "postal_code": "786282864",
            "telephone_number": "512-863-7000",
            "fax_number": "512-231-1087"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "4210 Spicewood Springs Rd Ste 205",
            "address_purpose": "LOCATION",
            "city": "Austin",
            "state": "TX",
            "postal_code": "787598654",
            "country_code": "US",
            "telephone_number": "512-346-5567",
            "fax_number": "512-231-1087",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "NIKKI",
        "middle_name": "LATOYA",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2009-11-20",
        "last_updated": "2022-08-03",
        "certification_date": "2022-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "CA",
            "license": "31459",
            "primary": false
        },
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "TX",
            "license": "12015",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Georgetown, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.