NPIMap

Individual provider Active NPI

Kelsey Thorne, PA-C

  • Physician Assistant
  • Logan, UT
National Provider Identifier
1093206922
Registry record updated Oct 20, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
13633355 Issued in UT
Practice address
2245 N 400 E Ste 201
Logan, UT 84341-1891
Phone
(435) 787-7001
Fax
(801) 216-8357
NPI assigned
May 26, 2018
Last updated
Oct 20, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 20, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 13633355 UT Primary

Addresses

Primary practice location

2245 N 400 E Ste 201
Logan, UT 84341-1891

Mailing address

2245 N 400 E Ste 201
Logan, UT 84341-1891
Phone (435) 787-7001

Other identifiers 1

IdentifierTypeStateIssuer
13633355-1206OtherUTSTATE LICENSE

Other names 1

  • Kelsey Girardelli Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231127001087 UT Practitioner - Physician Assistant 3476901810 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2023
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

3741 W 12600
Riverton, UT 84065-7215

5121 S Cottonwood St
Murray, UT 84107-5701

5131 S Cottonwood St
Murray, UT 84107-5701
Phone (801) 507-3888

700 S Hwy 99
Suite 3
Fillmore, UT 84631-5137
Phone (801) 357-4600

9690 S 1300
Suite 200
Sandy, UT 84094-3740
Phone (801) 507-3500

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
13633355UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Oct 14, 2024 Accepting new patients
Valley Obstetrics and Gynecology, PC CurrentSince Oct 11, 2023 Accepting new patients
Valley Obstetrics and Gynecology, P.C. CurrentSince Oct 11, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Oct 14, 2024 Accepting new patients
Bridgeway Integrated Healthcare Services Inc Counselor PastSince Nov 17, 2019 Accepting new patients
Valley Obstetrics and Gynecology, PC Past Accepting new patients
Valley Obstetrics and Gynecology, PC Past Accepting new patients
Ihc Health Services Inc Past Accepting new patients

Locations

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

2245 N 400 E
Ste 201
North Logan, UT 84341
Phone (435) 787-7001

585 N 500 W
Provo, UT 84601
Phone (801) 374-1801

3741 W 12600 S
Ste 120
Riverton, UT 84065

5169 S Cottonwood St
Ste 520
Salt Lake City, UT 84107
Phone (801) 507-3555

8th Ave C St
Salt Lake City, UT 84143
Phone (801) 269-2500

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

Organizations & group practices 10

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 2

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": "1527292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697760000000",
    "number": "1093206922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2245 N 400 E STE 201",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411891",
            "telephone_number": "435-787-7001",
            "fax_number": "801-216-8357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2245 N 400 E STE 201",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411891",
            "telephone_number": "435-787-7001",
            "fax_number": "801-216-8357"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORNE",
        "first_name": "KELSEY",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2018-05-26",
        "last_updated": "2023-10-20",
        "certification_date": "2023-10-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "13633355",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "STATE LICENSE",
            "identifier": "13633355-1206",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "KELSEY",
            "last_name": "GIRARDELLI",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

Verify at the official NPI Registry.