Individual provider Active NPI

Sylvester Lewis Thornton, NP

  • Family Nurse Practitioner
  • Clarksdale, MS
National Provider Identifier
1366042277
Registry record updated Oct 29, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
904131 Issued in MS
Practice address
1970 Hospital Dr
Clarksdale, MS 38614-7202
Phone
(662) 645-0275
NPI assigned
Oct 29, 2020
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 29, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse Practitioner 363LF0000X 904131 MS Primary

Addresses

Primary practice location

1970 Hospital Dr
Clarksdale, MS 38614-7202

Mailing address

PO Box 2053
Clarksdale, MS 38614-8053
Phone (662) 645-0275

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in MS
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210818000105 MS Practitioner - Nurse Practitioner 0244635092 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Upperline Healthcare, PC CurrentSince Sep 22, 2025 Accepting new patients
Upperline Healthcare, PC CurrentSince Sep 22, 2025 Accepting new patients
Aaron E. Henry Community Health Services Center, Inc CurrentSince Aug 3, 2021 Accepting new patients
Aaron E Henry Community Health CurrentSince Aug 3, 2021 Accepting new patients
Fast Pace Mississippi, PLLC PastSince Dec 12, 2021 Accepting new patients
Fast Pace Mississippi, PLLC Family PastSince Dec 1, 2018 Accepting new patients

Locations

600 Ohio Ave
Clarksdale, MS 38614
Phone (662) 624-2872

510 Highway 322
Clarksdale, MS 38614
Phone (662) 624-2504

7 Professional Pkwy
Ste 101
Hattiesburg, MS 39402
Phone (601) 781-1661

Organizations & group practices 6

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": "1603929600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603929600000",
    "number": "1366042277",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 2053",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386148053",
            "telephone_number": "662-645-0275"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1970 HOSPITAL DR",
            "city": "CLARKSDALE",
            "state": "MS",
            "postal_code": "386147202",
            "telephone_number": "662-645-0275"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "SYLVESTER",
        "middle_name": "LEWIS",
        "credential": "NP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2020-10-29",
        "last_updated": "2020-10-29",
        "certification_date": "2020-10-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MS",
            "license": "904131",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Clarksdale, MS

Sources for this page

Verify at the official NPI Registry.