NPIMap

Individual provider Active NPI

Bhavna Kapurji Thakor, M.D.

  • Internal Medicine Physician
  • Lake City, FL
National Provider Identifier
1245572817
Registry record updated May 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
License
70307 Issued in WI
Practice address
340 NW Commerce Dr
Lake City, FL 32055-4709
Phone
(386) 719-9000
NPI assigned
Mar 21, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 16, 2024

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Hospitalist Physician 208M00000X ME128941 FL
Hospitalist Physician 208M00000X 70307 WI
Internal Medicine Physician 207R00000X 70307 WI Primary
Hospitalist Physician 208M00000X MD191206 OR

Addresses

Primary practice location

340 NW Commerce Dr
Lake City, FL 32055-4709

Mailing address

340 NW Commerce Dr
Lake City, FL 32055-4709

Other practice location 1

611 N Saint Joseph Ave
Marshfield, WI 54449-1832
Phone (715) 387-1713

Other practice location 2

1818 N Meade St
Appleton, WI 54911-3454
Phone (920) 731-4101

Other identifiers 1

IdentifierTypeStateIssuer
100083617MedicaidWI

Electronic endpoints 6

TypeEndpointUseAffiliation
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address bthakor333193@direct-ehr-ssmhc.com Direct
Direct Messaging Address bthakor333193@direct-ehr-ssmhc.com Direct
Direct Messaging Address him@marshfieldclinichealthsystem.cernerdirect.com Other
FHIR URL https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/ Other
Direct Messaging Address bthakor166797@samhealth.direct-ci.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in WI
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20181218000106 WI Practitioner - HospitalistPractitioner - Internal Medicine 4789977729 Reassigns benefits to 10 organizations

Care Compare profile

Medicare Care Compare
Specialty
HospitalistAlso: Internal Medicine
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Baycare Aurora LLCGroup PAC ID 0244130557, 197 clinicians

Practice addresses (Care Compare)

2251 N Shore Dr
Rhinelander, WI 54501-6710
Phone (715) 361-2000

240 Maple St
Woodruff, WI 54568-9190
Phone (715) 356-8000

2845 Greenbrier Rd
Green Bay, WI 54311-6519
Phone (920) 288-8000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
70307WIMDInternal Medicine Physician
MD191206ORMDHospitalist Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Lakeshore Medical Clinic LTD CurrentSince Jan 1, 2022 Accepting new patients
Baycare Aurora, LLC Hospitalist CurrentSince Jun 26, 2022 Accepting new patients
MCHS Hospitals Inc CurrentSince Dec 19, 2018 Accepting new patients
Aurora Advanced Healthcare Inc CurrentSince Jan 1, 2022 Accepting new patients
Marshfield Clinic Inc CurrentSince Dec 19, 2018 Accepting new patients
MCHS Hospitals Inc Internal Medicine CurrentSince Dec 19, 2018 Accepting new patients
The Howard Young Medical Center, Inc. CurrentSince Jun 17, 2025 Accepting new patients
Lakeshore Medical Clinic, LLC CurrentSince Jan 1, 2022 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jun 17, 2025 Accepting new patients
MCHS Hospitals Inc Internal Medicine Current Accepting new patients
Aurora Health Care Metro, Inc. CurrentSince Jan 1, 2022 Accepting new patients
Aurora Medical Group, Inc. Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Aurora Advanced Healthcare, Inc. Internal Medicine CurrentSince Jan 1, 2022 Accepting new patients
Aspirus Rhinelander & Tomahawk Hospitals & Clinics, Inc. CurrentSince Jun 17, 2025 Accepting new patients
Aurora Medical Group, Inc. CurrentSince Jan 1, 2022 Accepting new patients

Locations

29980 Network Pl
Chicago, IL 60673

1818 N Meade St
Appleton, WI 54911
Phone (920) 731-4101

1818 N Meade St
Rm N255
Appleton, WI 54911
Phone (920) 730-3383

400 W Glen St
Crandon, WI 54520
Phone (715) 478-3318

1000 Starr Ave
Eau Claire, WI 54703
Phone (715) 858-4850

3501 Golf Rd
Eau Claire, WI 54701
Phone (715) 858-4200

3003 W Good Hope Rd
Glendale, WI 53209
Phone (414) 352-3100

2253 W Mason St
Green Bay, WI 54303
Phone (920) 327-7000

2845 Greenbrier Rd
Green Bay, WI 54311
Phone (920) 288-3388

1000 N Oak Ave
Marshfield, WI 54449
Phone (715) 387-5111

611 N Saint Joseph Ave
Marshfield, WI 54449
Phone (715) 387-1713

12203 N Corporate Pkwy
Mequon, WI 53092
Phone (262) 387-8200

2900 W Oklahoma Ave
Milwaukee, WI 53215
Phone (414) 385-2590

1020 N 12th St
Milwaukee, WI 53233
Phone (414) 219-3056

S74W16775 Janesville Rd
Muskego, WI 53150
Phone (414) 422-4747

130 2nd St
Neenah, WI 54956
Phone (920) 729-2063

2251 N Shore Dr
Rhinelander, WI 54501
Phone (715) 361-2300

2251 N Shore Dr
Ste 100
Rhinelander, WI 54501
Phone (715) 361-2074

2000 E Layton Ave
St Francis, WI 53235
Phone (414) 744-7880

401 W Mohawk Dr
Ste 100
Tomahawk, WI 54487
Phone (715) 453-7700

410 Dewey St
Wisconsin Rapids, WI 54494
Phone (715) 421-5257

240 Maple St
Woodruff, WI 54568
Phone (715) 356-8000

Interoperability endpoints

  • Direct secure messaging: bhavna.thakor@marshfieldclinichealthsystem.cernerdirect.com
  • Direct secure messaging: him@marshfieldclinichealthsystem.cernerdirect.com

Organizations & group practices 16

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.

View all 16

Hospital & facility affiliations 20

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

View all 20

NPI Registry JSON

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

{
    "created_epoch": "1363824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715817600000",
    "number": "1245572817",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "340 NW COMMERCE DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554709"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "340 NW COMMERCE DR",
            "city": "LAKE CITY",
            "state": "FL",
            "postal_code": "320554709",
            "telephone_number": "386-719-9000"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "611 N Saint Joseph Ave",
            "address_purpose": "LOCATION",
            "city": "Marshfield",
            "state": "WI",
            "postal_code": "544491832",
            "country_code": "US",
            "telephone_number": "715-387-1713",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1818 N Meade St",
            "address_purpose": "LOCATION",
            "city": "Appleton",
            "state": "WI",
            "postal_code": "549113454",
            "country_code": "US",
            "telephone_number": "920-731-4101",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THAKOR",
        "first_name": "BHAVNA",
        "middle_name": "KAPURJI",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-03-21",
        "last_updated": "2024-05-16",
        "certification_date": "2024-05-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "FL",
            "license": "ME128941",
            "primary": false
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "WI",
            "license": "70307",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "WI",
            "license": "70307",
            "primary": true
        },
        {
            "code": "208M00000X",
            "taxonomy_group": "",
            "desc": "Hospitalist",
            "state": "OR",
            "license": "MD191206",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "100083617",
            "state": "WI"
        }
    ],
    "endpoints": [
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bthakor333193@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bthakor333193@direct-ehr-ssmhc.com",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bthakor333193@direct-ehr-ssmhc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "bthakor333193@direct-ehr-ssmhc.com",
            "address_1": "3200 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462343",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "him@marshfieldclinichealthsystem.cernerdirect.com",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "Other",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "Other",
            "address_1": "1000 N Oak Ave",
            "city": "Marshfield",
            "state": "WI",
            "country_code": "US",
            "postal_code": "544495703",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "FHIR",
            "endpointTypeDescription": "FHIR URL",
            "endpoint": "https://fhir.ssmhc.com/fhir/api/FHIR/DSTU2/",
            "affiliation": "N",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "FHIR API",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CCD",
            "address_1": "3400 E Racine St",
            "city": "Janesville",
            "state": "WI",
            "country_code": "US",
            "postal_code": "535462344",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "bthakor166797@samhealth.direct-ci.com",
            "affiliation": "N",
            "address_1": "525 N Santiam Hwy",
            "city": "Lebanon",
            "state": "OR",
            "country_code": "US",
            "postal_code": "973554363",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Lake City, FL

Sources for this page

Verify at the official NPI Registry.