Kathleen Thorn, FNP-BC

Primary specialty

Family Nurse PractitionerTaxonomy code 363LF0000X

License

4704294760 Issued in MI

Practice address

770 Kenmoor Ave SE Ste 100
Grand Rapids, MI 49546-8602

Phone

(616) 272-3533

Fax

(616) 259-4839

NPI assigned

Sep 13, 2020

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in MI

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

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.

• Careconnectmd Michigan PC

  • Geriatric Medicine (Internal Medicine) Physician
  • Dearborn, MI
  • NPI 1477288348
  Medicare reassignment NPD
• Signify Health Medical Associates, PLLC

  • General Practice Physician
  • Dallas, TX
  • NPI 1750845863

  MI

  Medicare reassignment NPD
• Careline Hmi300 LLC

  dba Optimal Care Hospice

  • Community Based Hospice Care Agency
  • Grand Rapids, MI
  • NPI 1770257818
  NPD

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

{
    "created_epoch": "1599955200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1942815238",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "801 ROSEHILL RD",
            "city": "JACKSON",
            "state": "MI",
            "postal_code": "492021762",
            "telephone_number": "517-488-4884",
            "fax_number": "517-212-2009"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "770 KENMOOR AVE SE STE 100",
            "city": "GRAND RAPIDS",
            "state": "MI",
            "postal_code": "495468602",
            "telephone_number": "616-272-3533",
            "fax_number": "616-259-4839"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "5758 Cooley Lake Rd",
            "address_purpose": "LOCATION",
            "city": "Waterford",
            "state": "MI",
            "postal_code": "483273073",
            "country_code": "US",
            "telephone_number": "855-466-3631",
            "fax_number": "810-244-0226",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THORN",
        "first_name": "KATHLEEN",
        "name_prefix": "Mrs.",
        "credential": "FNP-BC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-09-13",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": "MI",
            "license": "4704294760",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brenda Marie Thorington, LMSW
• Lauren Thorington, MA CCC-SLP
• Matthew Thorington
• Einer S Thorlund III, PA-C
• Martha R Thormeier, LMSW
• Thornapple Dental PLC (Cascade Village Dental)
• Thornapple River Dentistry PLLC
• Barbara S Thornburg, MD
• Elizabeth Thornburg, BCBA, LBA
• Cal David Thorne, LLC

• Family Nurse Practitioner in Grand Rapids, MI
• Providers in Grand Rapids, MI by specialty
• Family Nurse Practitioner in Michigan

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.