Individual provider Active NPI

Glen Scott Thornton, D.C.

  • Nutrition Chiropractor
  • Brandon, FL
National Provider Identifier
1356416671
Registry record updated Aug 4, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nutrition ChiropractorTaxonomy code 111NN1001X
License
CH-0005881 Issued in FL
Practice address
906 Lithia Pinecrest Rd
Brandon, FL 33511-6121
Phone
(813) 685-7107
NPI assigned
Nov 21, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 4, 2010

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nutrition Chiropractor 111NN1001X CH-0005881 FL Primary

Addresses

Primary practice location

906 Lithia Pinecrest Rd
Brandon, FL 33511-6121

Mailing address

906 Lithia Pinecrest Rd
Brandon, FL 33511-6121
Phone (813) 685-7107

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

State licenses

LicenseStateTypeSpecialty
CH-0005881FLMDNutrition Chiropractor
5881FLMDRegistered Dietitian

Practice roles

OrganizationSpecialtyStatusNew patients
Thornton Chiropractic Center, P.a. Nutrition CurrentSince Mar 10, 2012 Accepting new patients
Champion Wellness Centers, Fishhawk, LLC PastSince Jun 1, 2026 Accepting new patients

Locations

906 Lithia Pinecrest Rd
Brandon, FL 33511
Phone (813) 409-3304

Organizations & group practices 2

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": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1280880000000",
    "number": "1356416671",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "906 LITHIA PINECREST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116121",
            "telephone_number": "813-685-7107"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "906 LITHIA PINECREST RD",
            "city": "BRANDON",
            "state": "FL",
            "postal_code": "335116121",
            "telephone_number": "813-685-7107"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "GLEN",
        "middle_name": "SCOTT",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2010-08-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NN1001X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Nutrition",
            "state": "FL",
            "license": "CH-0005881",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brandon, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 4, 2010; 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.