Individual provider Active NPI

Thomas Rees Checketts, DO

  • Obesity Medicine (Internal Medicine) Physician
  • Salt Lake City, UT
National Provider Identifier
1649905795
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obesity Medicine (Internal Medicine) PhysicianTaxonomy code 207RB0002X
License
14209307-1204 Issued in UT
Practice address
30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112-2353
Phone
(801) 581-2121
NPI assigned
Jul 22, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Obesity Medicine (Internal Medicine) Physician 207RB0002X 14209307-1204 UT Primary
Internal Medicine Physician 207R00000X 9324 NE

Addresses

Primary practice location

30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112-2353

Mailing address

30 N Mario Capecchi Dr RM 3N100
Salt Lake City, UT 84112-2353
Phone (801) 581-2121

Other practice location 1

7710 Mercy Rd Ste 202
Omaha, NE 68124-2353
Phone (402) 280-4392

Other identifiers 1

IdentifierTypeStateIssuer
9324OtherNENEBRASKA

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
I20260310001633 UT Practitioner - Internal Medicine 6901288851 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Internal Medicine
Education
University of North Texas HSC, College of Osteopathic Med, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

127 S 500
Suite 220
Salt Lake City, UT 84102-1982

4535 Dressler Rd NW
Canton, OH 44718-2545

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Regional Hospitalists LLC CurrentSince Feb 24, 2026 Accepting new patients
Tanner Memorial Clinic CurrentSince Jun 1, 2026 Accepting new patients
Utah Regional Hospitalists LLC CurrentSince Feb 24, 2026 Accepting new patients
Tanner Memorial Clinic Internal Medicine PastSince Jun 1, 2026 Accepting new patients

Locations

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

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": "1658448000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1743033600000",
    "number": "1649905795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "30 N MARIO CAPECCHI DR RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841122353",
            "telephone_number": "801-581-2121"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "30 N MARIO CAPECCHI DR RM 3N100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841122353",
            "telephone_number": "801-581-2121"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "7710 Mercy Rd Ste 202",
            "address_purpose": "LOCATION",
            "city": "Omaha",
            "state": "NE",
            "postal_code": "681242353",
            "country_code": "US",
            "telephone_number": "402-280-4392",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "CHECKETTS",
        "first_name": "THOMAS",
        "middle_name": "REES",
        "credential": "DO",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RB0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Obesity Medicine",
            "state": "UT",
            "license": "14209307-1204",
            "primary": true
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NE",
            "license": "9324",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "NEBRASKA",
            "identifier": "9324",
            "state": "NE"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

Verify at the official NPI Registry.