Individual provider Active NPI

Rodneesha Thornton

  • Prosthetics Case Management
  • Fayetteville, GA
National Provider Identifier
1255721528
Registry record updated Jan 28, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Prosthetics Case ManagementTaxonomy code 1744P3200X
License
CO121848 Issued in GA
Practice address
500 Lanier Ave W Ste 403
Fayetteville, GA 30214-7638
Phone
(916) 821-5392
NPI assigned
Jan 26, 2015
Last updated
Jan 28, 2015By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 28, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Prosthetics Case Management 1744P3200X CO121848 GA Primary

Addresses

Primary practice location

500 Lanier Ave W Ste 403
Fayetteville, GA 30214-7638

Mailing address

1209 Hunter CV
Jonesboro, GA 30238-7813
Phone (916) 821-5392

Other names 1

  • Neesha Thornton Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
CO121848GAMDProsthetics Case Management

NPI Registry JSON

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

{
    "created_epoch": "1422230400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1422403200000",
    "number": "1255721528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1209 HUNTER CV",
            "city": "JONESBORO",
            "state": "GA",
            "postal_code": "302387813",
            "telephone_number": "916-821-5392"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 LANIER AVE W STE 403",
            "city": "FAYETTEVILLE",
            "state": "GA",
            "postal_code": "302147638",
            "telephone_number": "916-821-5392"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "RODNEESHA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2015-01-26",
        "last_updated": "2015-01-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1744P3200X",
            "taxonomy_group": "",
            "desc": "Specialist, Prosthetics Case Management",
            "state": "GA",
            "license": "CO121848",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "NEESHA",
            "last_name": "THORNTON",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Fayetteville, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.