Individual provider Active NPI

Katherine Dana Thornton, PA-C

  • Physician Assistant
  • Dallas, TX
National Provider Identifier
1114428315
Registry record updated Dec 31, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
PA9118826 Issued in FL
Practice address
3900 Junius St Ste 415
Dallas, TX 75246-1615
Phone
(214) 820-7100
Fax
(214) 820-6863
NPI assigned
Feb 22, 2018
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 31, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Surgical Physician Assistant 363AS0400X
Physician Assistant 363A00000X PA9118826 FL Primary

Addresses

Primary practice location

3900 Junius St Ste 415
Dallas, TX 75246-1615

Mailing address

2607 Jennifer Hope Blvd
Longwood, FL 32779-4721
Phone (352) 356-3456

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250114002734 FL Practitioner - Physician Assistant 2264783166 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2017
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Florida Hospital Medical Group IncGroup PAC ID 0749186153, 1,735 clinicians

Practice addresses (Care Compare)

2600 Westhall LN
Maitland, FL 32751-7102
Phone (407) 200-2700

601 E Rollins St
Orlando, FL 32803-1248
Phone (407) 303-2570

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
PA9118826FLMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Florida Hospital Medical Group Inc CurrentSince Oct 7, 2024 Accepting new patients
Florida Hospital Medical Group Inc Physician Assistant CurrentSince Oct 7, 2024 Accepting new patients

Locations

2600 Westhall Ln
Ste 4
Maitland, FL 32751
Phone (407) 200-2700

2415 N Orange Ave
Ste 700
Orlando, FL 32804
Phone (407) 303-2474

Interoperability endpoints

  • Direct secure messaging: kthornton326422@direct.sw.org
  • Direct secure messaging: kthornton4086669@adventhealth.direct-ci.com

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 and National Provider Directory roles.

Hospital & facility affiliations 2

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1519257600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1735603200000",
    "number": "1114428315",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2607 JENNIFER HOPE BLVD",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327794721",
            "telephone_number": "352-356-3456"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3900 JUNIUS ST STE 415",
            "city": "DALLAS",
            "state": "TX",
            "postal_code": "752461615",
            "telephone_number": "214-820-7100",
            "fax_number": "214-820-6863"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "KATHERINE",
        "middle_name": "DANA",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-02-22",
        "last_updated": "2024-12-31",
        "certification_date": "2024-12-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "FL",
            "license": "PA9118826",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Dallas, TX

Sources for this page

Verify at the official NPI Registry.