Individual provider Active NPI

Rachael Kuehn Thornton, MD

  • Pediatrics Physician
  • Hattiesburg, MS
National Provider Identifier
1548889355
Registry record updated Aug 29, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
31023 Issued in MS
Practice address
4210 Lincoln Rd
Hattiesburg, MS 39402-3093
Phone
(601) 261-3500
Fax
(601) 261-3583
NPI assigned
Apr 11, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 29, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics Physician 208000000X 31023 MS Primary

Addresses

Primary practice location

4210 Lincoln Rd
Hattiesburg, MS 39402-3093

Mailing address

415 S 28TH Ave
Hattiesburg, MS 39401-7246
Phone (601) 261-3500

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230901003004 MS Practitioner - Pediatric Medicine 2567892177 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Hattiesburg Clinic, PA CurrentSince Jul 31, 2023 Accepting new patients
Hattiesburg Clinic PA CurrentSince Jul 31, 2023 Accepting new patients
University of Alabama Health Services Foundation, PC. PastSince Apr 1, 2020 Accepting new patients
Forrest County General Hospital Past Accepting new patients
Hattiesburg Clinic, PA Past Accepting new patients

Locations

415 S 28th Ave
Hattiesburg, MS 39401
Phone (601) 261-3606

Interoperability endpoints

  • Direct secure messaging: rthornton132000@directpatientrecord.com

Organizations & group practices 5

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": "1586563200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1693267200000",
    "number": "1548889355",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "415 S 28TH AVE",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394017246",
            "telephone_number": "601-261-3500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4210 LINCOLN RD",
            "city": "HATTIESBURG",
            "state": "MS",
            "postal_code": "394023093",
            "telephone_number": "601-261-3500",
            "fax_number": "601-261-3583"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "RACHAEL",
        "middle_name": "KUEHN",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-04-11",
        "last_updated": "2023-08-29",
        "certification_date": "2023-08-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208000000X",
            "taxonomy_group": "",
            "desc": "Pediatrics",
            "state": "MS",
            "license": "31023",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hattiesburg, MS

Sources for this page

Verify at the official NPI Registry.