Individual provider Active NPI

Michael Samuel Thurner, PT, DPT

  • Physical Therapist
  • Las Vegas, NV
National Provider Identifier
1164678256
Registry record updated Sep 23, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
2235 Issued in NV
Practice address
5920 S. Rainbow Blvd. Suite 1
Las Vegas, NV 89118
Phone
(702) 248-7903
Fax
(702) 248-7906
NPI assigned
Aug 8, 2008
Last updated
Sep 23, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 23, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 2235 NV Primary

Addresses

Primary practice location

5920 S. Rainbow Blvd. Suite 1
Las Vegas, NV 89118

Mailing address

5920 S. Rainbow Blvd Suite 1
Las Vegas, NV 89118
Phone (702) 248-7903

Other identifiers 1

IdentifierTypeStateIssuer
1164678256MedicaidNV

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20170522002330 HI Practitioner - Physical Therapist in Private Practice 8527123405 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2007
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Core Sports Analysis LLCGroup PAC ID 1850602418, 8 clinicians

Practice addresses (Care Compare)

599 Farrington Hwy
Suite 102
Kapolei, HI 96707-2028
Phone (808) 674-1142

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
2235NVMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Core Sports Honolulu LLC CurrentSince May 1, 2020 Accepting new patients
Physiotherapy Associates Inc PastSince Oct 1, 2011 Accepting new patients

Locations

1585 Kapiolani Blvd
Ste 1800
Honolulu, HI 96814
Phone (808) 545-2800

725 Kapiolani Blvd
Ste C103
Honolulu, HI 96813
Phone (808) 596-4650

599 Farrington Hwy
Ste 102
Kapolei, HI 96707
Phone (808) 674-1142

Organizations & group practices 3

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": "1218153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1442966400000",
    "number": "1164678256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5920 S. RAINBOW BLVD SUITE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-248-7903",
            "fax_number": "702-248-7906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5920 S. RAINBOW BLVD. SUITE 1",
            "city": "LAS VEGAS",
            "state": "NV",
            "postal_code": "89118",
            "telephone_number": "702-248-7903",
            "fax_number": "702-248-7906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURNER",
        "first_name": "MICHAEL",
        "middle_name": "SAMUEL",
        "name_prefix": "Mr.",
        "credential": "PT, DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2008-08-08",
        "last_updated": "2015-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NV",
            "license": "2235",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1164678256",
            "state": "NV"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Las Vegas, NV

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2015; 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.