Gary Thomas, CCSU, CTAT

Primary specialty

SpecialistTaxonomy code 174400000X

Practice address

1820 Sidewinder Dr Ste 100
Park City, UT 84060-7563

Phone

(310) 871-8738

NPI assigned

Dec 18, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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

{
    "created_epoch": "1513555200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1513555200000",
    "number": "1306352091",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7000 N GREENFIELD DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840985899",
            "telephone_number": "310-871-8738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1820 SIDEWINDER DR STE 100",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607563",
            "telephone_number": "310-871-8738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMAS",
        "first_name": "GARY",
        "name_prefix": "Mr.",
        "credential": "CCSU, CTAT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-12-18",
        "last_updated": "2017-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Liana Teteberg, BSN, PC, MHP
• Lane Clayton Thaut, D.O.
• The Dermatology House PC
• The Smart Clinic
• Think Head First
• Katherine Koplow Thomas
• Kathleen Thomas, FNP-C
• Lynn Thomas, LCSW
• Brianne Claire Thompson, MS, RD
• Colette Yolanda Thompson, COTA

• Specialist in Park City, UT
• Providers in Park City, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.