Individual provider Active NPI

Nathan F Pursifull, MD

  • Urology Physician
  • American Fork, UT
National Provider Identifier
1619161007
Registry record updated Jun 24, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urology PhysicianTaxonomy code 208800000X
License
12704181-1205 Issued in UT
Practice address
1159 E 200 N Ste 300
American Fork, UT 84003-2037
Phone
(801) 965-3600
NPI assigned
Aug 29, 2007
Last updated
Jun 24, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 24, 2025

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

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Urology Physician 208800000X 24825 NE
Urology Physician 208800000X 068279 GA
Urology Physician 208800000X 68279 GA
Urology Physician 208800000X 12704181-1205 UT Primary

Addresses

Primary practice location

1159 E 200 N Ste 300
American Fork, UT 84003-2037

Mailing address

2965 W 3500 S
West Valley City, UT 84119-3602
Phone (801) 965-3505

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: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220603001705 UT Practitioner - Urology 8729216205 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Urology
Education
Northwestern University Feinberg Medical School, 2006
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Granger Medical Clinic PCGroup PAC ID 3476465691, 192 clinicians

Practice addresses (Care Compare)

2965 W 3500
West Valley City, UT 84119-3602
Phone (801) 965-3600

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Prostate resection28

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
68279GAMDUrology Physician
24825NEMDUrology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Granger Medical Clinic PC CurrentSince Dec 31, 2023 Accepting new patients
Granger Medical Clinic PC Current Accepting new patients
Granger Medical Specialists LLC CurrentSince Jul 1, 2022 Accepting new patients
Granger Medical Specialists, LLC CurrentSince Jul 1, 2022 Accepting new patients
Rice and Lake Urology LLP Urology PastSince Jan 4, 2016 Accepting new patients

Locations

1159 E 200 N
American Fork, UT 84003
Phone (801) 855-2911

1159 E 200 N
Ste 300
American Fork, UT 84003
Phone (801) 756-7609

3000 N Triumph Blvd
Ste 340
Lehi, UT 84043
Phone (801) 225-4911

12391 S 4000 W
Riverton, UT 84096
Phone (801) 302-1700

995 W Levoy Dr
Taylorsville, UT 84123

7181 S Campus View Dr
West Jordan, UT 84084
Phone (801) 965-3505

7181 S Campus View Dr
Ste 200
West Jordan, UT 84084
Phone (801) 965-3505

2965 W 3500 S
West Valley City, UT 84119
Phone (801) 965-3505

3725 W 4100 S
West Valley City, UT 84120
Phone (801) 965-3545

Interoperability endpoints

  • Direct secure messaging: nathan.pursifull@westgahealth.gadirect.net

Organizations & group practices 5

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

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1188345600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1750723200000",
    "number": "1619161007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2965 W 3500 S",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841193602",
            "telephone_number": "801-965-3505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1159 E 200 N STE 300",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032037",
            "telephone_number": "801-965-3600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PURSIFULL",
        "first_name": "NATHAN",
        "middle_name": "F",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-08-29",
        "last_updated": "2025-06-24",
        "certification_date": "2025-06-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "NE",
            "license": "24825",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "068279",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "GA",
            "license": "68279",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "12704181-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.