Michael Cornel Thomas, APRN
Individual provider Active NPI Psychiatric/Mental Health Nurse Practitioner · Murray, UT
NPI 1306073671 · NPPES record last updated Jan 18, 2013
Key facts
- NPI
- 1306073671
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Psychiatric/Mental Health Nurse Practitioner 363LP0808X
- License
- 56467954405 (UT)
- Practice address
- 3944 S 400 E
Murray, UT 84107-1600 - Phone
- (801) 261-1442
- Fax
- (801) 261-9560
- NPI assigned
- Jun 15, 2009
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: Yes · Power mobility devices: Yes · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20110208000949 | UT | Practitioner - Nurse Practitioner | 4183804180 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Nurse Practitioner
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 56467954405 | UT | MD | Psychiatric/Mental Health Nurse Practitioner |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Complete Evaluations LLC | Current |
Accepting new patients | |
| David R. Albrecht O.D. P.C. | Past |
Accepting new patients |
Locations
2002 N Main St
Ste 3
Cedar City, UT 84721
Phone (435) 688-0648
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
350 W 300 N
Hyde Park, UT 84318
209 N State St
Ste B
Morgan, UT 84050
48 W 1500 N
Nephi, UT 84648
Phone (435) 623-3000
95 S 100 E
Ste 300
Payson, UT 84651
108 N Main St
Ste 202
Richfield, UT 84701
523 N State Road 198
Ste 203
Salem, UT 84653
607 Kirby Ln
Spanish Fork, UT 84660
Phone (801) 852-3805
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychiatric/Mental Health Nurse Practitioner | 363LP0808X | 56467954405 | UT | Yes |
Addresses
Primary practice location
3944 S 400 E
Murray, UT 84107-1600
Mailing address
1034 N 500 W
Provo, UT 84604-3380
Phone (801) 357-7380
Other providers in Murray, UT
- Christina Marie Thomas
- Graecey Thomas
- Katherine Page Thomas
- Kelly Lynn Thomas
- Maya Thomas
- Robin M Thomas
- Samuel Crandall Thomas
- Ajalea Thompson
- Randy Dale Thompson
- Sally B Thompson
All providers in Murray, UT · Psychiatric/Mental Health Nurse Practitioner in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 18, 2013. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.