Jason Daniel Thornburg, PA-C
Individual provider Active NPI Physician Assistant · Wilton, IA
NPI 1770838534 · NPPES record last updated Apr 17, 2014
Key facts
- NPI
- 1770838534
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Physician Assistant 363A00000X
- License
- 002312 (IA)
- Practice address
- 400 Ovesen Dr
Wilton, IA 52778-9612 - Phone
- (563) 732-2121
- Fax
- (563) 732-4232
- NPI assigned
- Jul 18, 2012
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 10
Hospital & facility affiliations 4
Medicare Care Compare profile
- Specialty
- Physician Assistant
- Education
- University of Iowa, RJ & L Carver College of Medicine, 2012
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Unity Healthcare
Practice addresses (Care Compare)
400 Ovesen Dr
Wilton, IA 52778-9612
Phone (563) 732-2121
Hospital & facility affiliations
- Unity Point at Home
- Trinity Muscatine
- Trinity - Bettendorf
- Trinity Rock Island
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in IA
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20121031000612 | IA | Practitioner - Physician Assistant | 2860642675 | Reassigns benefits to 2 organizations |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Physician Assistant
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Iowa Physicians Clinic Medical Foundation | Physician Assistant | Current |
Accepting new patients |
| Iowa Physicians Clinic Medical Foundation | Current |
Accepting new patients | |
| Unity Healthcare | Physician Assistant | Current |
Accepting new patients |
| St Luke'S Methodist Hospital | Current | Accepting new patients |
Locations
3415 53rd Ave
Bettendorf, IA 52722
Phone (563) 742-4350
4480 Utica Ridge Rd
Ste 160
Bettendorf, IA 52722
Phone (563) 742-5950
4480 Utica Ridge Rd
Ste 2230
Bettendorf, IA 52722
Phone (563) 742-5150
1518 Mulberry Ave
Muscatine, IA 52761
Phone (563) 262-4110
3426 N Port Dr
Ste 200
Muscatine, IA 52761
Phone (563) 264-9508
400 Ovesen Dr
Wilton, IA 52778
Phone (563) 732-2121
2701 17th St
Rock Island, IL 61201
Phone (309) 779-3200
Interoperability endpoints
- jthornburg162151@direct.unitypoint.org
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physician Assistant | 363A00000X | 002312 | IA | Yes |
Addresses
Primary practice location
400 Ovesen Dr
Wilton, IA 52778-9612
Mailing address
400 Ovesen Dr
Wilton, IA 52778-9612
Phone (563) 732-2121
Other providers in Wilton, IA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Apr 17, 2014. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.