Individual provider Active NPI

Grant Michael Thomson, PA-C

  • Physician Assistant
  • Murray, UT
National Provider Identifier
1710875398
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physician AssistantTaxonomy code 363A00000X
License
14247549-1206 Issued in UT
Practice address
5334 S Woodrow St Ste 100
Murray, UT 84107-5838
Phone
(801) 713-0600
Fax
(801) 713-0601
NPI assigned
Jun 24, 2025
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physician Assistant 363A00000X 14247549-1206 UT Primary
Student in an Organized Health Care Education/Training Program 390200000X

Addresses

Primary practice location

5334 S Woodrow St Ste 100
Murray, UT 84107-5838

Mailing address

5334 S Woodrow St Ste 100
Murray, UT 84107-5838
Phone (801) 713-0600

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
I20251017001393 UT Practitioner - Physician Assistant 6901393339 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physician Assistant
Education
Other, 2025
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mountain Medical Physician Specialists PCGroup PAC ID 5294639407, 29 clinicians

Practice addresses (Care Compare)

1600 W Antelope Dr
Layton, UT 84041-1142
Phone (801) 262-8120

3460 S Pioneer Pkwy
Salt Lake City, UT 84120-2049
Phone (801) 262-8120

5323 S Woodrow St
Murray, UT 84107-5841
Phone (801) 713-0600

Hospital & facility affiliations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Mountain Medical Physician Specialists PC CurrentSince Nov 1, 2025 Accepting new patients
Central Utah Radiology, PC PastSince Sep 14, 2025 Accepting new patients

Locations

5334 S Woodrow St
#100
Salt Lake City, UT 84107
Phone (801) 284-1702

5323 S Woodrow St
Salt Lake City, UT 84107
Phone (801) 261-8346

Organizations & group practices 2

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.

Hospital & facility affiliations 3

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": "1750723200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1710875398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5334 S WOODROW ST STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075838",
            "telephone_number": "801-713-0600",
            "fax_number": "801-713-0601"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5334 S WOODROW ST STE 100",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841075838",
            "telephone_number": "801-713-0600",
            "fax_number": "801-713-0601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "GRANT",
        "middle_name": "MICHAEL",
        "credential": "PA-C",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2025-06-24",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "14247549-1206",
            "primary": true
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Murray, UT

Sources for this page

Verify at the official NPI Registry.