Individual provider Active NPI

Robert S. Thornton, M.D.

  • Otolaryngology/Facial Plastic Surgery Physician
  • Shreveport, LA
National Provider Identifier
1851397855
Registry record updated Oct 7, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Otolaryngology/Facial Plastic Surgery PhysicianTaxonomy code 207YX0905X
License
03480R Issued in LA
Practice address
2121 Line Ave
Shreveport, LA 71104-2126
Phone
(318) 226-9441
Fax
(318) 425-3236
NPI assigned
Jun 23, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 7, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Otolaryngology/Facial Plastic Surgery Physician 207YX0905X 03480R LA Primary

Addresses

Primary practice location

2121 Line Ave
Shreveport, LA 71104-2126

Mailing address

2121 Line Ave
Shreveport, LA 71104-2126
Phone (318) 226-9441

Other identifiers 1

IdentifierTypeStateIssuer
1171662MedicaidLA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in LA
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

Enrollment IDStateProvider typePAC IDDetails
I20100825000011 LA Practitioner - OtolaryngologyPractitioner - Plastic and Reconstructive Surgery 0446395107 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
OtolaryngologyAlso: Plastic and Reconstructive Surgery
Education
University of Arkansas College of Medicine, 1970
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ear Nose and Throat Center a Medical CorporationGroup PAC ID 4486629540, 9 clinicians

Practice addresses (Care Compare)

2121 Line Ave
Shreveport, LA 71104-2126
Phone 3182269441232

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
75 of 100Reported as group

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ear Nose & Throat Center a Medical Corporation Otolaryngology CurrentSince Jul 1, 1966 Accepting new patients

Locations

8575 Fern Ave
Ste 103
Shreveport, LA 71105
Phone (318) 798-0759

2121 Line Ave
Shreveport, LA 71104
Phone (318) 226-9441

Interoperability endpoints

  • Direct secure messaging: rthornton@entcenter.gwaydirect.com

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.

Hospital & facility affiliations 5

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

NPI Registry JSON

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

{
    "created_epoch": "1119484800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1602028800000",
    "number": "1851397855",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2121 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042126",
            "telephone_number": "318-226-9441",
            "fax_number": "318-425-3236"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2121 LINE AVE",
            "city": "SHREVEPORT",
            "state": "LA",
            "postal_code": "711042126",
            "telephone_number": "318-226-9441",
            "fax_number": "318-425-3236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "ROBERT",
        "middle_name": "S.",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-06-23",
        "last_updated": "2020-10-07",
        "certification_date": "2020-10-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207YX0905X",
            "taxonomy_group": "",
            "desc": "Otolaryngology, Otolaryngology/Facial Plastic Surgery",
            "state": "LA",
            "license": "03480R",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1171662",
            "state": "LA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Shreveport, LA

Sources for this page

Verify at the official NPI Registry.