Ty D Thornock, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

2685-033 Issued in WI

Practice address

100 County Road B
Shawano, WI 54166-7072

Phone

(715) 524-2161

NPI assigned

Aug 9, 2006

Sex

Male

Sole proprietor

No

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 WI

Enrollment records 1

Specialty

Certified Registered Nurse Anesthetist (Crna)

Education

Other, 1998

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Association of Hospital Anesthesiologists SCGroup PAC ID 3476539875, 84 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Thedacare Medical Center - Shawano Hospital, Shawano, WI, CCN 521346
• Thedacare Medical Center - New London Hospital, New London, WI, CCN 521326

Medicare enrollment (NPD)

Enrolled

State licenses

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.

• Association of Hospital Anesthesiologists SC

  • Anesthesiology Physician
  • Neenah, WI
  • NPI 1720076474
  Medicare reassignment Care Compare group NPD
• Gastrointestinal Associates S.C.

  • Gastroenterology Physician
  • Wausau, WI
  • NPI 1760546949
  Medicare reassignment NPD
• Thedacare Medical Center - New London, Inc.

  • Critical Access Hospital
  • New London, WI
  • NPI 1538127220
  Medicare reassignment NPD
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Medicare reassignment NPD
• Thedacare, Incorporated

  • Family Medicine Physician
  • New London, WI
  • NPI 1376656959
  Medicare reassignment NPD
• Thedacare Medical Center - New London, Inc

  • Medicare Defined Swing Bed Hospital Unit
  • New London, WI
  • NPI 1639182926
  NPD
• Thedacare Medical Center - Shawano, Inc.

  • Community/Retail Pharmacy
  • Shawano, WI
  • NPI 1306516604
  NPD
• Wisconsin Institute of Urology SC

  • Urology Physician
  • Neenah, WI
  • NPI 1578872628
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Thedacare Medical Center - New London, Inc.

  • Critical Access Hospital
  • Clintonville, WI
  • NPI 1144675745
  Care Compare affiliation
• Thedacare Medical Center - New London, Inc.

  • Critical Access Hospital
  • New London, WI
  • NPI 1538127220
  Care Compare affiliation
• Thedacare Medical Center - Shawano, Inc.

  • Critical Access Hospital
  • Shawano, WI
  • NPI 1548260839
  Care Compare affiliation

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1521244800000",
    "number": "1720098197",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "122 E COLLEGE AVE",
            "city": "APPLETON",
            "state": "WI",
            "postal_code": "549115794",
            "telephone_number": "920-996-3264",
            "fax_number": "920-830-5970"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 COUNTY ROAD B",
            "city": "SHAWANO",
            "state": "WI",
            "postal_code": "541667072",
            "telephone_number": "715-524-2161"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1405 Mill St",
            "address_purpose": "LOCATION",
            "city": "New London",
            "state": "WI",
            "postal_code": "549612155",
            "country_code": "US",
            "telephone_number": "920-531-2000",
            "fax_number": "920-531-2098",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORNOCK",
        "first_name": "TY",
        "middle_name": "D",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2018-03-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "WI",
            "license": "2685-033",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "43382500",
            "state": "WI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Shantel Thomas
• Thomas Thomas, MD
• Bentley Jessica Mae Thomason, MD
• Heidi Lee Thompson, P.T.A.
• Ann Renae Thornock, APNP - FAMILY
• Mark Robert Tolsma, COTA
• Ann M Tousignant, MD
• Tower Clock Eye Center SC
• Corrina Jolinda Tuma, PTA
• Under the Rainbow LLC

• Certified Registered Nurse Anesthetist in Shawano, WI
• Providers in Shawano, WI by specialty
• Certified Registered Nurse Anesthetist in Wisconsin

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 17, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• 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.