Individual provider Active NPI

Briana Jessica Thornton, AU.D.

  • Audiologist
  • Mesa, AZ
National Provider Identifier
1912288333
Registry record updated Mar 8, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
AudiologistTaxonomy code 231H00000X
License
DA7445 Issued in AZ
Practice address
5202 E. Main Street, Ste. 105
Mesa, AZ 85205-8038
Phone
(480) 218-1328
Fax
(480) 218-1330
NPI assigned
Aug 30, 2011
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Audiologist 231H00000X DA7445 AZ Primary

Addresses

Primary practice location

5202 E. Main Street, Ste. 105
Mesa, AZ 85205-8038

Mailing address

5202 E Main St Ste 105
Mesa, AZ 85205-8065
Phone (480) 218-1328

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ, TX2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160414000317 AZ Practitioner - Qualified Audiologist 9133423908 Reassigns benefits to 1 organization
I20190320002642 TX Practitioner - Qualified Audiologist 9133423908 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
DA7445AZMDAudiologist

Practice roles

OrganizationSpecialtyStatusNew patients
San Carlos Apache Healthcare Corporation CurrentSince Jan 26, 2019 Accepting new patients
San Carlos Apache Healthcare Corporation CurrentSince Jan 26, 2019 Accepting new patients

Locations

103 Medicine Way Rd
Peridot, AZ 85542
Phone (928) 475-1200

Organizations & group practices 3

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": "1314662400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1457395200000",
    "number": "1912288333",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5202 E MAIN ST STE 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058065",
            "telephone_number": "480-218-1328",
            "fax_number": "480-218-1330"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5202 E. MAIN STREET, STE. 105",
            "city": "MESA",
            "state": "AZ",
            "postal_code": "852058038",
            "telephone_number": "480-218-1328",
            "fax_number": "480-218-1330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNTON",
        "first_name": "BRIANA",
        "middle_name": "JESSICA",
        "credential": "AU.D.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2011-08-30",
        "last_updated": "2016-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "231H00000X",
            "taxonomy_group": "",
            "desc": "Audiologist",
            "state": "AZ",
            "license": "DA7445",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Mesa, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 8, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.