Jaclyn Blair Thornton, NP

Primary specialty

Adult Medicine PhysicianTaxonomy code 207QA0505X

License

10003878 Issued in OR

Practice address

Pain Specialist It Southern Oregon
825 Bennett Ave
Medford, OR 97504

Phone

(541) 779-5228

NPI assigned

Oct 19, 2018

Last updated

Mar 10, 2023By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Jaclyn Blair Lucchese Former name

Medicare fee-for-service enrollment

Enrolled in SC, OR2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Specialty

Nurse Practitioner

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Pain Care of Oregon LLCGroup PAC ID 3779550785, 12 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Asante Rogue Regional Medical Center Hospital, Medford, OR, CCN 380018
• Asante Three Rivers Medical Center Hospital, Grants Pass, OR, CCN 380002
• Sky Lakes Medical Center Hospital, Klamath Falls, OR, CCN 380050
• Asante Ashland Community Hospital Hospital, Ashland, OR, CCN 380005
• Fairchild Medical Center Hospital, Yreka, CA, CCN 051316

Medicare enrollment (NPD)

Enrolled

Credentials

Nurse Practitioner

State licenses

Practice roles

Locations

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.

• Pain Care of Oregon, LLC

  dba Pain Specialists of Southern Oregon

  • Interventional Pain Medicine Physician
  • Medford, OR
  • NPI 1699793505
  Medicare reassignment Care Compare group NPD
• Southeast Lung & Critical Care Specialists, PC

  dba Southeast Lung Associates

  • Pulmonary Disease Physician
  • Bluffton, SC
  • NPI 1164789251
  Medicare reassignment NPD
• Theoria Medical

  • Internal Medicine Physician
  • Novi, MI
  • NPI 1609362375

  SC

  Medicare reassignment NPD
• Southeast Lung & Critical Care Specialists

  dba Southeast Lung Associates

  • Pulmonary Disease Physician
  • Baxley, GA
  • NPI 1366064164
  NPD
• Southeast Lung & Critical Care Specialists, P.C.

  dba Southeast Lung Associates

  • Specialist
  • Savannah, GA
  • NPI 1740244276
  NPD

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

• Asante

  dba Asante Rogue Regional Medical Center

  • General Acute Care Hospital
  • Medford, OR
  • NPI 1770587107
  Care Compare affiliation
• Asante Ashland Community Hospital, LLC

  • General Acute Care Hospital
  • Ashland, OR
  • NPI 1730628827
  Care Compare affiliation
• Asante Three Rivers Medical Center, LLC

  • General Acute Care Hospital
  • Grants Pass, OR
  • NPI 1801891809
  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • Occupational Therapist
  • Klamath Falls, OR
  • NPI 1134270911

  Hospital

  Care Compare affiliation
• Sky Lakes Medical Center Inc

  • General Acute Care Hospital
  • Klamath Falls, OR
  • NPI 1659340370
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1093892275
  Care Compare affiliation
• Siskiyou Hospital, Inc.

  dba Fairchild Medical Center

  • Critical Access Hospital
  • Yreka, CA
  • NPI 1952701369
  Care Compare affiliation

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

{
    "created_epoch": "1539907200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678406400000",
    "number": "1255807087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 CLAIRE DR",
            "city": "HILTON HEAD ISLAND",
            "state": "SC",
            "postal_code": "299283937",
            "telephone_number": "901-485-3766"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "PAIN SPECIALIST IT SOUTHERN OREGON",
            "address_2": "825 BENNETT AVE",
            "city": "MEDFORD",
            "state": "OR",
            "postal_code": "97504",
            "telephone_number": "541-779-5228"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "9 Claire Dr",
            "address_purpose": "LOCATION",
            "city": "Hilton Head Island",
            "state": "SC",
            "postal_code": "299283937",
            "country_code": "US",
            "telephone_number": "901-485-3766",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "JACLYN",
        "middle_name": "BLAIR",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-10-19",
        "last_updated": "2023-03-10",
        "certification_date": "2023-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "SC",
            "license": "22326",
            "primary": false
        },
        {
            "code": "207QA0505X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Adult Medicine",
            "state": "OR",
            "license": "10003878",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JACLYN",
            "last_name": "LUCCHESE",
            "middle_name": "BLAIR",
            "credential": "NP",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Tara Rae Thompson, APRN
• Thomson Anesthesia LLC
• David Ryland Thornberry, M.D.
• Daniel Bryson Thornley, PA-C
• Courtney Thornton, LCSW
• Michael Scott Thorson
• Lynzee Lee Thrapp
• Thrifty Payless Inc (Rite Aid Pharmacy 05384)
• Thriving After the Storm LLC
• Cason Jaymes Thurman

• Adult Medicine Physician in Medford, OR
• Providers in Medford, OR by specialty
• Adult Medicine Physician in Oregon

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 10, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.