Individual provider Active NPI

Ryan L Thueson, PA-C

  • Physician Assistant
  • Murray, UT
National Provider Identifier
1023359080
Registry record updated Apr 8, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
8528275-1206 Issued in UT
Practice address
5171 S Cottonwood St Ste 210
Murray, UT 84107-5718
Phone
(801) 507-3380
NPI assigned
Mar 14, 2013
Last updated
Apr 8, 2026By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 8, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 8528275-1206 UT Primary
Physician Assistant 363A00000X 5369 AZ

Addresses

Primary practice location

5171 S Cottonwood St Ste 210
Murray, UT 84107-5718

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService Other Bluemark LLC / Office Ally

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID, NV3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20141222001994 UT Practitioner - Physician Assistant 1759520059 Reassigns benefits to 2 organizations
I20210415002247 ID Practitioner - Physician Assistant 1759520059 Reassigns benefits to 2 organizations
I20230622001847 NV Practitioner - Physician Assistant 1759520059 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
St Lukes Clinic-Treasure Valley LLCGroup PAC ID 4981878402, 1,155 clinicians
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3277 E Louise Dr
Suite 150
Meridian, ID 83642-9373
Phone (208) 706-8346

5121 S Cottonwood St
Murray, UT 84107-5701

5171 S Cottonwood St
Suite 210
Murray, UT 84107-5718
Phone (801) 507-3380

608 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

610 W Hays St
Boise, ID 83702-5511
Phone (208) 381-5970

8 TH Ave and C St
LDS Hosp Eeg Phys GRP
Salt Lake City, UT 84143
Phone (801) 507-7000

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

State licenses

LicenseStateTypeSpecialty
5369AZMDPhysical Therapist
8528275-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 15, 2014 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 15, 2014 Accepting new patients
Ihc Health Services Inc CurrentSince Apr 20, 2023 Accepting new patients
St Lukes Clinic-Treasure Valley LLC Internal Medicine CurrentSince Mar 22, 2021 Accepting new patients
Ihc Health Services Inc Internal Medicine CurrentSince Apr 20, 2023 Accepting new patients
After Hours Medical LLC, Dba Medallus Medical CurrentSince Oct 15, 2016 Accepting new patients
Ihc Health Services Inc Past Accepting new patients
St Lukes Regional Medical Center Past Accepting new patients

Locations

190 E Bannock St
Boise, ID 83712
Phone (208) 381-2378

610 W Hays St
Boise, ID 83702
Phone (208) 345-3530

3277 E Louise Dr
Ste 100
Meridian, ID 83642
Phone (208) 706-5217

444 Hospital Way
Pocatello, ID 83201
Phone (208) 232-6214

2650 N Tenaya Way
Ste 201
Las Vegas, NV 89128
Phone (702) 736-7154

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1915 W 5950 S
Roy, UT 84067
Phone (801) 387-8100

5171 S Cottonwood St
Ste 210
Salt Lake City, UT 84107

400 C St
Salt Lake Cty, UT 84143
Phone (435) 688-4080

5121 S Cottonwood St
Salt Lake Cty, UT 84107
Phone (801) 408-8998

1380 E Medical Center Dr
Ste 4500
St George, UT 84790
Phone (435) 251-2501

1300 SE Cardinal Ct
Ste 190
Vancouver, WA 98683
Phone (360) 448-4479

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 4

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": "1363219200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775606400000",
    "number": "1023359080",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5171 S COTTONWOOD ST STE 210",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075718",
            "telephone_number": "801-507-3380"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THUESON",
        "first_name": "RYAN",
        "middle_name": "L",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-03-14",
        "last_updated": "2026-04-08",
        "certification_date": "2026-04-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "8528275-1206",
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "AZ",
            "license": "5369",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "https://esmd.officeally.io:8291/Gateway/DocumentSubmission/2_0/NhinService/XDRReguestService",
            "affiliation": "Y",
            "endpointDescription": "2.16.840.1.113883.3.2019.3",
            "affiliationName": "Bluemark LLC / Office Ally",
            "use": "OTHER",
            "useDescription": "Other",
            "useOtherDescription": "CMS esMD eMDR",
            "address_1": "1300 SE Cardinal Ct Ste 190",
            "city": "Vancouver",
            "state": "WA",
            "country_code": "US",
            "postal_code": "986839683",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.