Organization Active NPI

Thornton Chiropractic Life Center, PA

  • Chiropractor
  • New Bern, NC
National Provider Identifier
1356541700
Registry record updated Jul 24, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
ChiropractorTaxonomy code 111N00000X
License
2657 Issued in NC
Legal business name
THORNTON CHIROPRACTIC LIFE CENTER, PA
Practice address
2404 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4424
Phone
(252) 638-8121
Fax
(252) 633-3401
NPI assigned
Jul 24, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 24, 2007

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

Authorized official

Name
Dr. Amy Thornton Gatlin, DCNPI 1427008192
Title
President/Chiropractor
Phone
(252) 638-8121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
ChiropractorGroup: 193400000X SINGLE SPECIALTY GROUP 111N00000X 2657 NC Primary

Addresses

Primary practice location

2404 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4424

Mailing address

2404 Dr Martin Luther King Jr Blvd
New Bern, NC 28562-4424
Phone (252) 638-8121

Other identifiers 2

IdentifierTypeStateIssuer
890837NMedicaidNC
0837NOtherNCBCBS

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080229000466 NC Part B Supplier - Clinic/Group Practice 7810071735 Receives reassigned benefits from 1 practitioner
Practice locations: New Bern, NC

National Provider Directory

National Provider Directory

Locations

2404 Martin Luther King Jr Blvd
New Bern, NC 28562
Phone (252) 638-8121

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1185235200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1185235200000",
    "number": "1356541700",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2404 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624424",
            "telephone_number": "252-638-8121",
            "fax_number": "252-633-3401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2404 DR MARTIN LUTHER KING JR BLVD",
            "city": "NEW BERN",
            "state": "NC",
            "postal_code": "285624424",
            "telephone_number": "252-638-8121",
            "fax_number": "252-633-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THORNTON CHIROPRACTIC LIFE CENTER, PA",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-24",
        "last_updated": "2007-07-24",
        "status": "A",
        "authorized_official_last_name": "GATLIN",
        "authorized_official_first_name": "AMY",
        "authorized_official_middle_name": "THORNTON",
        "authorized_official_title_or_position": "PRESIDENT/CHIROPRACTOR",
        "authorized_official_telephone_number": "252-638-8121",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DC"
    },
    "taxonomies": [
        {
            "code": "111N00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Chiropractor",
            "state": "NC",
            "license": "2657",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "890837N",
            "state": "NC"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "0837N",
            "state": "NC"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New Bern, NC

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 24, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.