NPIMap

Individual provider Active NPI

McKennan J. Thurston, MD

  • Sports Medicine (Family Medicine) Physician
  • Morgan, UT
National Provider Identifier
1194088856
Registry record updated Apr 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Medicine (Family Medicine) PhysicianTaxonomy code 207QS0010X
License
9817986-1205 Issued in UT
Practice address
4166 Summer Ridge Rd
Morgan, UT 84050-9344
Phone
(801) 809-3766
Fax
(801) 516-0639
NPI assigned
Jun 19, 2012
Last updated
Apr 17, 2024By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 56747 MN
Sports Medicine (Family Medicine) Physician 207QS0010X 9817986-1205 UT Primary

Addresses

Primary practice location

4166 Summer Ridge Rd
Morgan, UT 84050-9344

Mailing address

4166 Summer Ridge Rd
Morgan, UT 84050-9344
Phone (801) 809-3766

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
I20160624001733 UT Practitioner - Family Practice 6507002573 Reassigns benefits to 4 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Other, 2012
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians
Skilled MD LLCGroup PAC ID 8820576705, 2 clinicians

Practice addresses (Care Compare)

Morgan, UT 84050
Phone (801) 809-3766

1750 E 3100
Layton, UT 84040-2406
Phone (801) 773-4840

316 N Sunny MDWS
Morgan, UT 84050-6823
Phone (801) 821-7920

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of tissue19
Removal of skin lesions1-10
Removal of nail tissue1-10
Skin biopsy1-10

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
56747MNMDFamily Medicine Physician
9817986-1205UTMDSports Medicine (Family Medicine) Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Biomedical Health Partners LLC CurrentSince Jul 22, 2023 Accepting new patients
Skilled MD, LLC Sports Medicine CurrentSince Oct 6, 2025 Accepting new patients
Tanner Memorial Clinic Current Accepting new patients
Tanner Memorial Clinic CurrentSince Aug 1, 2016 Accepting new patients
Grab Healthcare, LLC Family Medicine CurrentSince Nov 19, 2025 Accepting new patients
Tanner Memorial Clinic Family Medicine CurrentSince Aug 1, 2016 Accepting new patients

Locations

380 N 400 W
Kaysville, UT 84037
Phone (801) 547-9500

1750 E 3100 N
Layton, UT 84040
Phone (385) 405-2252

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

3443 W 5600 S
Roy, UT 84067
Phone (801) 825-6400

406 W South Jordan Pkwy
Ste 450
South Jordan, UT 84095
Phone (801) 561-8398

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: mckennan.thurston.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 6

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 5

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": "1340064000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1713312000000",
    "number": "1194088856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4166 SUMMER RIDGE RD",
            "city": "MORGAN",
            "state": "UT",
            "postal_code": "840509344",
            "telephone_number": "801-809-3766",
            "fax_number": "801-516-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4166 SUMMER RIDGE RD",
            "city": "MORGAN",
            "state": "UT",
            "postal_code": "840509344",
            "telephone_number": "801-809-3766",
            "fax_number": "801-516-0639"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "MCKENNAN",
        "middle_name": "J.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-06-19",
        "last_updated": "2024-04-17",
        "certification_date": "2024-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "56747",
            "primary": false
        },
        {
            "code": "207QS0010X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Sports Medicine",
            "state": "UT",
            "license": "9817986-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Morgan, UT

Sources for this page

Verify at the official NPI Registry.