Individual provider Active NPI

Thor Patrick Mongie, D.C.

  • Radiology Chiropractor
  • Payson, UT
National Provider Identifier
1104988989
Registry record updated Aug 2, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Radiology ChiropractorTaxonomy code 111NR0200X
License
B00981 Issued in NV
Practice address
2 N Main St
Payson, UT 84651
Phone
(702) 417-8522
NPI assigned
Dec 15, 2006
Last updated
Aug 2, 2018By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 2, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Radiology Chiropractor 111NR0200X B00981 NV Primary

Addresses

Primary practice location

2 N Main St
Payson, UT 84651

Mailing address

2 N Main St
Payson, UT 84651-2239
Phone (702) 417-8522

Other practice location 1

2820 W Charleston Blvd
Suite A-6
Las Vegas, NV 89102-1942
Phone (702) 258-7860

Other practice location 2

2820 W Charleston Blvd
Suite A-6
Las Vegas, NV 89102-1942
Phone (702) 258-7860

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180731002470 UT Practitioner - Chiropractic 8325293749 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Chiropractic
Education
Palmer College Chiropractic - Davenport, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

2 N Main St
Payson, UT 84651-2239
Phone (702) 417-8522

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
B00981NVMDRadiology Chiropractor

Practice roles

OrganizationSpecialtyStatusNew patients
Thor Mongie D C LTD Radiology CurrentSince Jun 1, 2003 Accepting new patients
Balanced Health of Payson Inc Radiology CurrentSince May 26, 2018 Accepting new patients

Locations

2820 W Charleston Blvd
#A6
Las Vegas, NV 89102
Phone (702) 258-7860

2 N Main St
Payson, UT 84651
Phone (702) 417-8522

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1166140800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1533168000000",
    "number": "1104988989",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2 N MAIN ST",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "846512239",
            "telephone_number": "702-417-8522"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 N MAIN ST",
            "city": "PAYSON",
            "state": "UT",
            "postal_code": "84651",
            "telephone_number": "702-417-8522"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2820 W Charleston Blvd",
            "address_2": "Suite A-6",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021942",
            "country_code": "US",
            "telephone_number": "702-258-7860",
            "fax_number": "702-258-5487",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2820 W Charleston Blvd",
            "address_2": "Suite A-6",
            "address_purpose": "LOCATION",
            "city": "Las Vegas",
            "state": "NV",
            "postal_code": "891021942",
            "country_code": "US",
            "telephone_number": "702-258-7860",
            "fax_number": "702-258-5487",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MONGIE",
        "first_name": "THOR",
        "middle_name": "PATRICK",
        "name_prefix": "Dr.",
        "credential": "D.C.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-12-15",
        "last_updated": "2018-08-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "111NR0200X",
            "taxonomy_group": "",
            "desc": "Chiropractor, Radiology",
            "state": "NV",
            "license": "B00981",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Payson, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.