Individual provider Active NPI

Lane Clayton Thaut, D.O.

  • Emergency Medicine Physician
  • Park City, UT
National Provider Identifier
1174984058
Registry record updated Dec 3, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Medicine PhysicianTaxonomy code 207P00000X
License
DOS-1915 Issued in HI
Practice address
1743 S Sidewinder Drive Unit 114
Park City, UT 84060
Phone
(307) 840-9834
NPI assigned
Mar 18, 2016
Last updated
Dec 3, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 3, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine Physician 207P00000X 17163 CA
Obesity Medicine (Preventive Medicine) Physician 2083B0002X DOS-1915 HI
Emergency Medicine Physician 207P00000X DOS-1915 HI Primary
Emergency Medicine Physician 207P00000X R4911 TX

Addresses

Primary practice location

1743 S Sidewinder Drive Unit 114
Park City, UT 84060

Mailing address

1743 Sidewinder Dr Unit 114
Park City, UT 84060-7322

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in CA, HI, WI, CO, UT, NY6 enrollments
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 6

Enrollment IDStateProvider typePAC IDDetails
I20200506001496 CA Practitioner - Emergency Medicine 2567792005 Reassigns benefits to 1 organization
I20201019001798 HI Practitioner - Emergency Medicine 2567792005 Reassigns benefits to 2 organizations
I20230912002376 WI Practitioner - Family Practice 2567792005 Reassigns benefits to 1 organization
I20240910002253 CO Practitioner - Emergency Medicine 2567792005 Reassigns benefits to 1 organization
I20241230001524 UT Practitioner - Emergency Medicine 2567792005 Reassigns benefits to 1 organization
I20250929001062 NY Practitioner - Emergency Medicine 2567792005 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Emergency Medicine
Education
Rocky Vista University College of Osteopathic Med, 2016
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
RP Medical LLCGroup PAC ID 3779877485, 19 clinicians

Practice addresses (Care Compare)

270 Dairy Rd
Suite 239
Kahului, HI 96732-2986
Phone (808) 667-6161

800 E Blackhawk Ave
Prairie Du Chien, WI 53821-1698
Phone (608) 326-0808

800 W Ave S
La Crosse, WI 54601-8806
Phone (608) 785-0940

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of nail tissue1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Osteopathy

State licenses

LicenseStateTypeSpecialty
R4911TXMDEmergency Medicine Physician
DOS-1915HIMDObesity Medicine (Preventive Medicine) Physician
17163CAMDPhysical Rehabilitation Occupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Woodland Emergency Physicians Medical Group Inc Emergency Medicine CurrentSince Mar 15, 2020 Accepting new patients
RP Medical LLC General Practice CurrentSince Oct 1, 2020 Accepting new patients
True North Medical of Stony Brook, P.C. Family Medicine CurrentSince Oct 1, 2025 Accepting new patients
Emerald Medical Practice PC CurrentSince Jul 11, 2024 Accepting new patients
Hawaii Emergency Physicians Associated Inc Emergency Medicine CurrentSince Mar 24, 2021 Accepting new patients
Mayo Clinic Health System-Southwest Wisconsin Region, Inc. CurrentSince Aug 28, 2023 Accepting new patients
Cloud Health Medical Group of California, P.C. Family Medicine Past Accepting new patients

Locations

710 Lakeway Dr
Ste 200
Sunnyvale, CA 94085
Phone (408) 372-6205

1325 Cottonwood St
Woodland, CA 95695
Phone (530) 662-3961

4770 Baseline Rd
Ste 200
Boulder, CO 80303
Phone (307) 840-9834

1201 Hays St
Tallahassee, FL 32301
Phone (855) 522-7233

289 S Culver St
Lawrenceville, GA 30046
Phone (404) 458-0809

270 Dairy Rd
Ste 239
Kahului, HI 96732

640 Ulukahiki St
Kailua, HI 96734
Phone (808) 261-3326

79-1019 Haukapila St
Kealakekua, HI 96750
Phone (808) 322-4413

128 Lehua St
Wahiawa, HI 96786
Phone (808) 621-4330

801 Adlai Stevenson Dr
Springfield, IL 62703
Phone 4153603833 ext. 03833

475 Hillside Ave
Ste 4
Needham Hgts, MA 02494

3410 Belle Chase Way
Ste 600
Lansing, MI 48911
Phone (517) 999-9020

200 1st St SW
Rochester, MN 55905
Phone (507) 266-4850

100 Charles Ewing Blvd
Ste 160
Trenton, NJ 08628
Phone (833) 484-6359

2119 Merrick Rd
Merrick, NY 11566
Phone (516) 377-2820

1111 Marcus Ave
Ste M04
New Hyde Park, NY 11042
Phone (585) 736-3650

10 W 37th St
Fl 5
New York, NY 10018
Phone (929) 296-1624

1160 Dublin Rd
Ste 400
Columbus, OH 43215
Phone (502) 439-2617

211 E 7th St
Ste 620
Austin, TX 78701
Phone (415) 742-8411

1743 Sidewinder Dr
Unit 114
Park City, UT 84060
Phone (307) 840-9834

800 E Blackhawk Ave
Prairie du Chien, WI 53821
Phone (608) 326-0808

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H3359
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H5989

Interoperability endpoints

  • Direct secure messaging: lthaut375924@northwell.direct-ci.com
  • Direct secure messaging: lane.thaut.2@30093.direct.athenahealth.com

Organizations & group practices 8

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": "1458259200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1764720000000",
    "number": "1174984058",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1743 SIDEWINDER DR UNIT 114",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607322"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1743 S SIDEWINDER DRIVE UNIT 114",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "307-840-9834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THAUT",
        "first_name": "LANE",
        "middle_name": "CLAYTON",
        "name_prefix": "Dr.",
        "credential": "D.O.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2016-03-18",
        "last_updated": "2025-12-03",
        "certification_date": "2025-12-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "CA",
            "license": "17163",
            "primary": false
        },
        {
            "code": "2083B0002X",
            "taxonomy_group": "",
            "desc": "Preventive Medicine, Obesity Medicine",
            "state": "HI",
            "license": "DOS-1915",
            "primary": false
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "HI",
            "license": "DOS-1915",
            "primary": true
        },
        {
            "code": "207P00000X",
            "taxonomy_group": "",
            "desc": "Emergency Medicine",
            "state": "TX",
            "license": "R4911",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Park City, UT

Sources for this page

Verify at the official NPI Registry.