Active NPI
Ross Kelley Thueson, M.D.
- Internal Medicine Physician
- Spanish Fork, UT
National Provider Identifier
1689039976
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 17508-1205
- Practice address
- 62 E. 3450 N.
Spanish Fork, UT 84660-5734 - Phone
- (801) 360-2909
- NPI assigned
- Dec 31, 2015
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Internal Medicine Physician | 207R00000X | 17508-1205 | UT | Primary |
Addresses
Primary practice location
62 E. 3450 N.
Spanish Fork, UT 84660-5734
Mailing address
62 E 3450 N
Spanish Fork, UT 84660-5734
Phone (801) 360-2909
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 176508-1205 | Other | UT | MEDICAL LICENSE |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 17508-1205 | UT | MD | Internal Medicine Physician |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1451520000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1451520000000",
"number": "1689039976",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "62 E 3450 N",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846605734",
"telephone_number": "801-360-2909"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "62 E. 3450 N.",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846605734",
"telephone_number": "801-360-2909"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THUESON",
"first_name": "ROSS",
"middle_name": "KELLEY",
"credential": "M.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2015-12-31",
"last_updated": "2015-12-31",
"status": "A"
},
"taxonomies": [
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "17508-1205",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "MEDICAL LICENSE",
"identifier": "176508-1205",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Spanish Fork, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 31, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.