Carroll Wayne Thornburg, D.O.

Primary specialty

Addiction Medicine (Family Medicine) PhysicianTaxonomy code 207QA0401X

License

G9230 Issued in TX

Practice address

725 S Mesa Hills Dr
Suite 1, BLDG. 1
El Paso, TX 79912-5568

Phone

(915) 887-3414

Fax

(915) 585-1682

NPI assigned

Jul 8, 2005

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in TX

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

Specialty

Family PracticeAlso: Addiction Medicine

Education

Other, 1984

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

El Paso Community MHMRGroup PAC ID 3476532383, 54 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Osteopathy

Practice roles

Locations

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.

• El Paso Community MHMR

  • Multi-Specialty Clinic/Center
  • El Paso, TX
  • NPI 1649345869
  Medicare reassignment Care Compare group NPD
• El Paso Community MHMR

  • Family Medicine Physician
  • El Paso, TX
  • NPI 1033806278

  Addiction Medicine

  NPD
• Medmark Treatment Centers of Texas, Inc.

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Paso, TX
  • NPI 1891169215
  NPD
• Vcphcs VII, LLC

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Windcrest, TX
  • NPI 1992966584
  NPD
• El Paso Community MHMR

  • Substance Use Disorder Rehabilitation Clinic/Center
  • El Paso, TX
  • NPI 1073968749
  NPD (past)

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

{
    "created_epoch": "1120780800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1448236800000",
    "number": "1568460962",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "725 S MESA HILLS DR",
            "address_2": "SUITE 1, BLDG. 1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125568",
            "telephone_number": "915-887-3414",
            "fax_number": "915-585-1682"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "725 S MESA HILLS DR",
            "address_2": "SUITE 1, BLDG. 1",
            "city": "EL PASO",
            "state": "TX",
            "postal_code": "799125568",
            "telephone_number": "915-887-3414",
            "fax_number": "915-585-1682"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBURG",
        "first_name": "CARROLL",
        "middle_name": "WAYNE",
        "credential": "D.O.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2005-07-08",
        "last_updated": "2015-11-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207QA0401X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Addiction Medicine",
            "state": "TX",
            "license": "G9230",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "E0068",
            "state": "NM"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Justin L Thompson, ATP
• Peter M Thompson, MD
• Stephanie Caroline Thompson, COTA
• William Edward Thompson, D.D.S.
• Nicole Thor, DO
• Claudia Elizabeth Thornton, MD
• Patricia Jo Thornton
• Jessica Thouvenell
• Dana Thrash, APRN
• Thrive Counseling & Wellness PLLC

• Addiction Medicine (Family Medicine) Physician in El Paso, TX
• Providers in El Paso, TX by specialty
• Addiction Medicine (Family Medicine) Physician in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 23, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.