Individual provider Active NPI

John L. Thorne, MD

  • Anesthesiology Physician
  • Grapevine, TX
National Provider Identifier
1639200538
Registry record updated Oct 11, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
Anesthesiology PhysicianTaxonomy code 207L00000X
License
M6421 Issued in TX
Practice address
2938 S Creekwood Dr
Grapevine, TX 76051-5665
Phone
(817) 372-2068
NPI assigned
Mar 9, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 11, 2012

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Anesthesiology Physician 207L00000X M6421 TX Primary

Addresses

Primary practice location

2938 S Creekwood Dr
Grapevine, TX 76051-5665

Mailing address

2938 S Creekwood Dr
Grapevine, TX 76051-5665
Phone (817) 372-2068

Other identifiers 5

IdentifierTypeStateIssuer
188139303MedicaidTX
8CD641OtherTXBCBS
188139302MedicaidTX
P00957376OtherTXRAILROAD MEDICARE
188139304MedicaidTX

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
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Minerva Labs LLC CurrentSince Mar 30, 2025 Accepting new patients

Locations

1203 S White Chapel Blvd
Ste 150
Southlake, TX 76092
Phone (817) 333-9898

Organizations & group practices 1

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": "1173398400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1349913600000",
    "number": "1639200538",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2938 S CREEKWOOD DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515665",
            "telephone_number": "817-372-2068"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2938 S CREEKWOOD DR",
            "city": "GRAPEVINE",
            "state": "TX",
            "postal_code": "760515665",
            "telephone_number": "817-372-2068"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNE",
        "first_name": "JOHN",
        "middle_name": "L.",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-09",
        "last_updated": "2012-10-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": "TX",
            "license": "M6421",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188139303",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS",
            "identifier": "8CD641",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188139302",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "P00957376",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "188139304",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Grapevine, TX

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 11, 2012; 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.