Individual provider Active NPI

Dustin Thompson, FNP-C

  • Primary Care Nurse Practitioner
  • Layton, UT
National Provider Identifier
1609452960
Registry record updated May 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Nurse PractitionerTaxonomy code 363LP2300X
License
9784958-4405 Issued in UT
Practice address
425 S 100 W
Layton, UT 84041
Phone
(801) 773-4840
NPI assigned
Mar 18, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 13, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Nurse Practitioner 363LP2300X 9784958-8900 UT
Primary Care Nurse Practitioner 363LP2300X 9784958-4405 UT Primary

Addresses

Primary practice location

425 S 100 W
Layton, UT 84041

Mailing address

2412 W 1125 S
Syracuse, UT 84075-7049
Phone (801) 682-6955

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
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 1

Enrollment IDStateProvider typePAC IDDetails
I20210527000789 UT Practitioner - Nurse Practitioner 1254730021 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tanner Memorial ClinicGroup PAC ID 4284547985, 251 clinicians

Practice addresses (Care Compare)

425 S 100
Layton, UT 84041-5356
Phone (801) 773-4840

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

State licenses

LicenseStateTypeSpecialty
9784958-8900UTMDPrimary Care Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Tanner Memorial Clinic Internal Medicine Current Accepting new patients
Tanner Memorial Clinic CurrentSince Apr 29, 2024 Accepting new patients
Tanner Memorial Clinic CurrentSince Apr 29, 2024 Accepting new patients

Locations

1756 W Antelope Dr
Layton, UT 84041
Phone (801) 525-8726

425 S 100 W
Layton, UT 84041
Phone (801) 682-8708

Interoperability endpoints

  • Direct secure messaging: dustin.thompson.p1@direct.tannerclinic.nextgenshare.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1616025600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715558400000",
    "number": "1609452960",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2412 W 1125 S",
            "city": "SYRACUSE",
            "state": "UT",
            "postal_code": "840757049",
            "telephone_number": "801-682-6955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 S 100 W",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "84041",
            "telephone_number": "801-773-4840"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMPSON",
        "first_name": "DUSTIN",
        "credential": "FNP-C",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-03-18",
        "last_updated": "2024-05-13",
        "certification_date": "2024-05-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "9784958-8900",
            "primary": false
        },
        {
            "code": "363LP2300X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Primary Care",
            "state": "UT",
            "license": "9784958-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Layton, UT

Sources for this page

Verify at the official NPI Registry.