Individual provider Active NPI

Nikki Thornton, LCSW

  • Social Worker
  • White Hall, AR
National Provider Identifier
1215343207
Registry record updated Mar 24, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
5913-C Issued in AR
Practice address
109 Frankie LN
White Hall, AR 71602-2685
Phone
(870) 247-3588
Fax
(870) 247-2072
NPI assigned
Jul 10, 2014
Last updated
Mar 24, 2021By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 24, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 5913-C AR Primary

Addresses

Primary practice location

109 Frankie LN
White Hall, AR 71602-2685

Mailing address

109 Frankie LN
White Hall, AR 71602-2685
Phone (870) 247-3588

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20211005002817 AR Practitioner - Clinical Social Worker 3072898188 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

3322 W 34TH Ave
Pine Bluff, AR 71603-5500
Phone (870) 619-9018

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
5913-CARMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Mom Counseling LLC CurrentSince Sep 1, 2021 Accepting new patients
BHC Pinnacle Pointe Hospital, Inc. PastSince Jan 5, 2020 Accepting new patients
Uhs of Benton, Inc. Past Accepting new patients
BHC Pinnacle Pointe Hospital LLC PastSince Jan 5, 2020 Accepting new patients
Fulfilled Life Counseling, LLC Past Accepting new patients

Locations

3041 W 28th Ave
Pine Bluff, AR 71603
Phone (501) 517-0905

3322 W 34th Ave
Pine Bluff, AR 71603
Phone (870) 606-2334

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
North Little Rock Community Health CenterLittle Rock, AR, CCN 041925 Federally qualified health center Corporate Officer (1.47%) Feb 1, 2016

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 5

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": "1404950400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616544000000",
    "number": "1215343207",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "109 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022685",
            "telephone_number": "870-247-3588",
            "fax_number": "870-247-2072"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "109 FRANKIE LN",
            "city": "WHITE HALL",
            "state": "AR",
            "postal_code": "716022685",
            "telephone_number": "870-247-3588",
            "fax_number": "870-247-2072"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "NIKKI",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-07-10",
        "last_updated": "2021-03-24",
        "certification_date": "2021-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "AR",
            "license": "5913-C",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Hall, AR

Sources for this page

Verify at the official NPI Registry.