Individual provider Active NPI

Dane Thurston, PA

  • Physician Assistant
  • Ephraim, UT
National Provider Identifier
1225255235
Registry record updated Aug 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
362840-1206 Issued in UT
Practice address
152 N 400 W
Ephraim, UT 84627-5549
Phone
(435) 283-4065
Fax
(435) 462-8407
NPI assigned
Apr 19, 2007
Last updated
Aug 14, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 14, 2025

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 362840-1206 UT Primary

Addresses

Primary practice location

152 N 400 W
Ephraim, UT 84627-5549

Mailing address

152 N 400 W
Ephraim, UT 84627-5549
Phone (435) 283-8400

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, UT2 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 2

Enrollment IDStateProvider typePAC IDDetails
I20140214001057 TX Practitioner - Physician Assistant 4183853120 Reassigns benefits to 5 organizations
I20250904003229 UT Practitioner - Physician Assistant 4183853120 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Central Utah Counseling CenterGroup PAC ID 6305743618, 21 clinicians

Practice addresses (Care Compare)

152 N 400
Ephraim, UT 84627-5549
Phone (435) 283-8400

Hospital & facility affiliations

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
362840-1206UTMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Brian Nelson MD PLLC Current Accepting new patients
Central Utah Counseling Center CurrentSince Jun 21, 2025 Accepting new patients
LHP Texas MD Services Inc CurrentSince Jan 15, 2014 Accepting new patients

Locations

1208 W Henderson St
Cleburne, TX 76033
Phone (682) 317-1500

800 W Central Texas Expy
Harker Heights, TX 76548
Phone (254) 618-4933

152 N 400 W
Ephraim, UT 84627
Phone (435) 283-8400

Organizations & group practices 7

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 1

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": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1755129600000",
    "number": "1225255235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "152 N 400 W",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846275549",
            "telephone_number": "435-283-8400",
            "fax_number": "435-283-8401"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "152 N 400 W",
            "city": "EPHRAIM",
            "state": "UT",
            "postal_code": "846275549",
            "telephone_number": "435-283-4065",
            "fax_number": "435-462-8407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "DANE",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-04-19",
        "last_updated": "2025-08-14",
        "certification_date": "2025-08-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "362840-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Ephraim, UT

Sources for this page

Verify at the official NPI Registry.