Active NPI
Lam William Thanadabout, MD
- Hospitalist Physician
- Logan, UT
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Hospitalist Physician
- License
- 6990986-1205
- Practice address
- 1400 N 500 E
Logan, UT 84341-2455 - Phone
- (435) 752-0422
- NPI assigned
- Apr 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 6990986-8017 | UT | |
| Hospitalist Physician | 208M00000X | 6990986-1205 | UT | Primary |
Addresses
Primary practice location
1400 N 500 E
Logan, UT 84341-2455
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 752-0422
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: No
- Hospice: Yes
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Hospitalist
- Education
- University of Utah School of Medicine, 2002
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
4401 Harrison Blvd
Ogden, UT 84403-3195
Phone (801) 387-3364
Hospital & facility affiliations
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6990986-8017 | UT | MD | Internal Medicine Physician |
| 6990986-1205 | UT | MD | Hospitalist Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services, Inc. | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Ihc Health Services Inc | Current | Accepting new patients | |
| Northwest Allied Physicians LLC | Internal Medicine | Past | Accepting new patients |
| Northwest Allied Physicians, LLC | Past | Accepting new patients |
Locations
777 Hospital Way
Ste 202
Pocatello, ID 83201
Phone (208) 239-2640
700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555
1400 N 500 E
North Logan, UT 84341
Phone (435) 716-1000
1350 N 500 E
North Logan, UT 84341
Phone (435) 716-2800
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 and National Provider Directory roles.
-
- Multi-Specialty Clinic/Center
- Sandy, UT
- NPI 1942325154
-
dba Cedar City Heart Clinic
- Cardiovascular Disease Physician
- Cedar City, UT
- NPI 1922132729
-
dba St George Adolescent Partial Hospitalization
- Psychiatry Physician
- St George, UT
- NPI 1023843844
-
- General Practice Physician
- Tucson, AZ
- NPI 1003833179
Internal Medicine
-
- Durable Medical Equipment & Medical Supplies
- Oro Valley, AZ
- NPI 1821302910
Hospital & facility affiliations 1
Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.
-
dba Intermountain Health Logan Regional Hospital
- General Acute Care Hospital
- Logan, UT
- NPI 1831108497
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1145577600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1495756800000",
"number": "1649236316",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "435-752-0422"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N 500 E",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412455",
"telephone_number": "435-752-0422"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THANADABOUT",
"first_name": "LAM",
"middle_name": "WILLIAM",
"name_prefix": "Dr.",
"credential": "MD",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-04-21",
"last_updated": "2017-05-26",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "6990986-8017",
"primary": false
},
{
"code": "208M00000X",
"taxonomy_group": "",
"desc": "Hospitalist",
"state": "UT",
"license": "6990986-1205",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 26, 2017; 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.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.