Individual provider Active NPI

Hannah Elizabeth Thornton

  • Pediatric Nurse Practitioner
  • East Syracuse, NY
National Provider Identifier
1346521929
Registry record updated Mar 26, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nurse PractitionerTaxonomy code 363LP0200X
License
F382585 Issued in NY
Practice address
6700 Kirkville Rd
Suite a
East Syracuse, NY 13057-9305
Phone
(315) 463-2013
Fax
(315) 463-2019
NPI assigned
Sep 8, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 26, 2021

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 2295111 MA
Pediatric Nurse Practitioner 363LP0200X 4791 CT
Pediatric Nurse Practitioner 363LP0200X F382585 NY Primary

Addresses

Primary practice location

6700 Kirkville Rd
Suite a
East Syracuse, NY 13057-9305

Mailing address

6700 Kirkville Rd
Suite a
East Syracuse, NY 13057-9305
Phone (315) 463-2013

Other identifiers 1

IdentifierTypeStateIssuer
05397719MedicaidNY

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)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
2295111MAMDNurse Practitioner
F382585NYMDPediatric Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Child Health Care Associates Practice of Pediatrics CurrentSince Apr 6, 2021 Accepting new patients
Shoreline Pediatrics & Adolescent Medicine, P.C. Past Accepting new patients
Riverbend Medical Group, Inc Past Accepting new patients

Locations

6700 Kirkville Rd
Ste A
East Syracuse, NY 13057
Phone (315) 463-2013

8100 Oswego Rd
Ste 220
Liverpool, NY 13090
Phone (315) 652-6551

Interoperability endpoints

  • Direct secure messaging: hannahthorton@chca.medentdirect.com

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1315440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1616716800000",
    "number": "1346521929",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6700 KIRKVILLE RD",
            "address_2": "SUITE A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579305",
            "telephone_number": "315-463-2013",
            "fax_number": "315-463-2019"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6700 KIRKVILLE RD",
            "address_2": "SUITE A",
            "city": "EAST SYRACUSE",
            "state": "NY",
            "postal_code": "130579305",
            "telephone_number": "315-463-2013",
            "fax_number": "315-463-2019"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "HANNAH",
        "middle_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-09-08",
        "last_updated": "2021-03-26",
        "certification_date": "2021-03-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "MA",
            "license": "2295111",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "CT",
            "license": "4791",
            "primary": false
        },
        {
            "code": "363LP0200X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Pediatrics",
            "state": "NY",
            "license": "F382585",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "05397719",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in East Syracuse, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 26, 2021; 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.