Gary Thornberg, CRNA

Primary specialty

Certified Registered Nurse AnesthetistTaxonomy code 367500000X

License

025911 Issued in ME

Practice address

149 North St
Waterville, ME 04901-4974

Phone

(207) 622-1959

Fax

(207) 430-4007

NPI assigned

Jun 5, 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

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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.

• Waterville Anesthesia Associates, P.a.

  • Anesthesiology Physician
  • Waterville, ME
  • NPI 1346295987
  NPD (past)

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

{
    "created_epoch": "1149465600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1387324800000",
    "number": "1821037052",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 MEDICAL CENTER PKWY",
            "city": "AUGUSTA",
            "state": "ME",
            "postal_code": "043308160",
            "telephone_number": "207-622-1959",
            "fax_number": "207-430-4007"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "149 NORTH ST",
            "city": "WATERVILLE",
            "state": "ME",
            "postal_code": "049014974",
            "telephone_number": "207-622-1959",
            "fax_number": "207-430-4007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNBERG",
        "first_name": "GARY",
        "credential": "CRNA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-06-05",
        "last_updated": "2013-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": "ME",
            "license": "025911",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "274300099",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Richard M Thomas, PHD
• Barbara Thompson, DPT
• Craig R Thompson, MD
• Kristen Thompson
• Nicholas Jay Thompson, ATC, CSCS
• Meghan Elizabeth Thornberg, PA-C
• June Thornton-Marsh, LCSW
• Tracey Thornton, PMHNP-BC
• Jane L Thurston, LCSW
• James Tibbetts, LADC

• Certified Registered Nurse Anesthetist in Waterville, ME
• Providers in Waterville, ME by specialty
• Certified Registered Nurse Anesthetist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2013; 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.