Thomas Mifflin

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

11203807-1206 Issued in UT

Practice address

721 East 12200 South
Draper, UT 84020

Phone

(801) 369-8989

Fax

(801) 704-9741

NPI assigned

Jul 16, 2019

Sex

Male

Sole proprietor

No

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

Eligible to order & refer

• Part B services: No
• Medical equipment: Yes
• Home health: No
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

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.

• Ogden Internal Medicine & Urology LLC

  • Internal Medicine Physician
  • Ogden, UT
  • NPI 1003001553
  NPD (past)

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

{
    "created_epoch": "1563235200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1603065600000",
    "number": "1508418856",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "672 W 400 S STE 201",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846633170",
            "telephone_number": "801-369-8989",
            "fax_number": "801-704-9741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "721 EAST 12200 SOUTH",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "84020",
            "telephone_number": "801-369-8989",
            "fax_number": "801-704-9741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIFFLIN",
        "first_name": "THOMAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2019-07-16",
        "last_updated": "2020-10-19",
        "certification_date": "2020-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "11203807-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kevin Meyers
• Michelle Muenzenmeyer
• Brandon Shawn Mickelson, PA-C
• Taylor Middlemiss
• Melinda M Midgley, MD
• Delaney Miklos, DNP, FNP-C
• Michael Stephen Miles, PA-C
• Charisse Miller
• Janessa Ann Miller
• Jocelyn C. S. Miller, PT, DPT

• Physician Assistant in Draper, UT
• Providers in Draper, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.