NPIMap

Individual provider Active NPI

Thomas Ralph Jensen, PHARMD

  • Pharmacist
  • Provo, UT
National Provider Identifier
1417385014
Registry record updated Nov 20, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
PharmacistTaxonomy code 183500000X
License
7725489-1701 Issued in UT
Practice address
3179 N Canyon Rd
Provo, UT 84604-3916
Phone
(801) 377-2002
Fax
(801) 377-2007
NPI assigned
Oct 17, 2013
Sex
Male
Sole proprietor
No

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Doctor of Pharmacy

State licenses

LicenseStateTypeSpecialty
RPH-0013823ORMDPharmacist
7725489-1701UTMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Thrifty Payless Inc Past Accepting new patients
Canyon Pharmaceutical, LLC Pharmacist PastSince Nov 24, 2019 Accepting new patients
Thrifty Payless Inc Past Accepting new patients

Specialties & licenses 2

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Pharmacist 183500000X RPH-0013823 OR
Pharmacist 183500000X 7725489-1701 UT Primary

Addresses

NPPES NPI Registry

Primary practice location

3179 N Canyon Rd
Provo, UT 84604-3916

Mailing address

421 E 2825 N
Provo, UT 84604-4240
Phone (801) 822-8086

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Nov 20, 2019.

{
    "created_epoch": "1381968000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1574208000000",
    "number": "1417385014",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "421 E 2825 N",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846044240",
            "telephone_number": "801-822-8086"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3179 N CANYON RD",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043916",
            "telephone_number": "801-377-2002",
            "fax_number": "801-377-2007"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "THOMAS",
        "middle_name": "RALPH",
        "credential": "PHARMD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-10-17",
        "last_updated": "2019-11-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "OR",
            "license": "RPH-0013823",
            "primary": false
        },
        {
            "code": "183500000X",
            "taxonomy_group": "",
            "desc": "Pharmacist",
            "state": "UT",
            "license": "7725489-1701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 20, 2019; 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.