Active NPI
Kim L Thornton, MD
- Reproductive Endocrinology Physician
- Waltham, MA
National Provider Identifier
1992742191
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Reproductive Endocrinology Physician
- License
- 153109
- Practice address
- 130 2D Avenue
Boston Ivf - the Waltham Center
Waltham, MA 02451 - Phone
- (781) 434-6500
- Fax
- (781) 434-6501
- NPI assigned
- May 31, 2006
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 8
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Reproductive Endocrinology Physician | 207VE0102X | 153109 | MA | Primary |
| Reproductive Endocrinology Physician | 207VE0102X | MD10471 | RI | |
| Reproductive Endocrinology Physician | 207VE0102X | 029664 | CT | |
| Reproductive Endocrinology Physician | 207VE0102X | 35.052652 | OH | |
| Gynecology Physician | 207VG0400X | 153109 | MA | |
| Gynecology Physician | 207VG0400X | MD10471 | RI | |
| Gynecology Physician | 207VG0400X | 029664 | CT | |
| Gynecology Physician | 207VG0400X | 35.052652 | OH |
Addresses
Primary practice location
130 2D Avenue
Boston Ivf - the Waltham Center
Waltham, MA 02451
Mailing address
130 2D Avenue
Boston Ivf - the Waltham Center
Waltham, MA 02451
Phone (781) 434-6500
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 3088707 | Medicaid | MA |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 029664 | CT | MD | Reproductive Endocrinology Physician |
| 153109 | MA | MD | Gynecology Physician |
| 35.052652 | OH | MD | Gynecology Physician |
| MD10471 | RI | MD | Gynecology Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Boston Ivf, Inc. | Reproductive Endocrinology | Past | Accepting new patients |
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.
-
- Reproductive Endocrinology Physician
- Waltham, MA
- NPI 1326122839
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1149033600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1211241600000",
"number": "1992742191",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "130 2D AVENUE",
"address_2": "BOSTON IVF - THE WALTHAM CENTER",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02451",
"telephone_number": "781-434-6500",
"fax_number": "781-434-6501"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "130 2D AVENUE",
"address_2": "BOSTON IVF - THE WALTHAM CENTER",
"city": "WALTHAM",
"state": "MA",
"postal_code": "02451",
"telephone_number": "781-434-6500",
"fax_number": "781-434-6501"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORNTON",
"first_name": "KIM",
"middle_name": "L",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-05-31",
"last_updated": "2008-05-20",
"status": "A"
},
"taxonomies": [
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "MA",
"license": "153109",
"primary": true
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "RI",
"license": "MD10471",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "CT",
"license": "029664",
"primary": false
},
{
"code": "207VE0102X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Reproductive Endocrinology",
"state": "OH",
"license": "35.052652",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "MA",
"license": "153109",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "RI",
"license": "MD10471",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "CT",
"license": "029664",
"primary": false
},
{
"code": "207VG0400X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology, Gynecology",
"state": "OH",
"license": "35.052652",
"primary": false
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "3088707",
"state": "MA"
}
],
"endpoints": [],
"other_names": []
}
Other providers in Waltham, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.