Salvador Mireles Thorn, PA-C

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

0010-11074 Issued in NC

Practice address

Womack Army Medical Center 2817 Rock Merritt Avenue
Fort Liberty, NC 28310-0001

Phone

(910) 907-8922

Fax

(910) 907-6069

NPI assigned

Aug 29, 2017

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other names 1

• Salvador Mireles Thorn Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1503964800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1733788800000",
    "number": "1982121059",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2817 ROCK MERRITT AVENUE WOMACK ARMY MEDICAL CENTER",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283104994",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "WOMACK ARMY MEDICAL CENTER 2817 ROCK MERRITT AVENUE",
            "city": "FORT LIBERTY",
            "state": "NC",
            "postal_code": "283100001",
            "telephone_number": "910-907-8922",
            "fax_number": "910-907-6069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIRELES THORN",
        "first_name": "SALVADOR",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2017-08-29",
        "last_updated": "2024-12-10",
        "certification_date": "2024-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "NC",
            "license": "0010-11074",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "SALVADOR",
            "last_name": "THORN",
            "middle_name": "MIRELES",
            "credential": "PA-C",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Brian Phillip Milam, M.D.
• Marvin Milkowich, PHARMD
• Arthur Lloyd Miller, PSY.D.
• John Alexander Millward, PA-C
• Christopher Thomas Minton, PA-C
• Melissa Victoria Mojica, LCSW, LCAS
• Melanie Molz, PA-C
• Judith Anne Moon
• Kane D Morgan, PA-C
• Kimberly Evans Moser, MA

• Physician Assistant in Fort Liberty, NC
• Providers in Fort Liberty, NC by specialty
• Physician Assistant in North Carolina

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2024; 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.