Individual provider Active NPI

Gary Lee Thorne, D.C.

  • Chiropractor
  • Fayetteville, NC
National Provider Identifier
1184606741
Registry record updated Mar 14, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
1753 Issued in NC
Practice address
517 Beaumont Rd
Fayetteville, NC 28304-4424
Phone
(910) 323-5522
Fax
(910) 483-9497
NPI assigned
Nov 18, 2005
Last updated
Mar 14, 2014By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 14, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Chiropractor 111N00000X 1753 NC Primary

Addresses

Primary practice location

517 Beaumont Rd
Fayetteville, NC 28304-4424

Mailing address

517 Beaumont Rd
Fayetteville, NC 28304-4424
Phone (910) 323-5522

Other identifiers 4

IdentifierTypeStateIssuer
89013GNMedicaidNC
013GNOtherNCBCBS GROUP
08878OtherNCBLUE CROSS BLUE SHIELD
8908878MedicaidNC

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20080317000657 NC Practitioner - Chiropractic 9739264607 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Life Chiropractic College - West, 1989
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

517 Beaumont Rd
Fayetteville, NC 28304-4424
Phone (910) 323-5522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
1753NCMDAddiction (Substance Use Disorder) Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Cross Creek Chiropractic Clinic PA Chiropractor CurrentSince Jun 1, 2002 Accepting new patients
Jeffrey K. Baldwin Chiropractor PastSince Jun 1, 2002 Accepting new patients
Chiropractic Health and Wellness Center, P. a. Chiropractor Past Accepting new patients

Locations

517 Beaumont Rd
Fayetteville, NC 28304
Phone (910) 323-5522

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": "1132272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1394755200000",
    "number": "1184606741",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "517 BEAUMONT RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044424",
            "telephone_number": "910-323-5522",
            "fax_number": "910-483-9497"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "517 BEAUMONT RD",
            "city": "FAYETTEVILLE",
            "state": "NC",
            "postal_code": "283044424",
            "telephone_number": "910-323-5522",
            "fax_number": "910-483-9497"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNE",
        "first_name": "GARY",
        "middle_name": "LEE",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-11-18",
        "last_updated": "2014-03-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "1753",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "89013GN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS GROUP",
            "identifier": "013GN",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "08878",
            "state": "NC"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "8908878",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Fayetteville, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 14, 2014; 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.