Organization Active NPI

Forge Psychiatry PLLC

  • Addiction Psychiatry Physician
  • Bountiful, UT
National Provider Identifier
1720934615
Registry record updated Mar 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction Psychiatry PhysicianTaxonomy code 2084P0802X
Legal business name
FORGE PSYCHIATRY PLLC
Practice address
450 S 400 E Ste 501
Bountiful, UT 84010-4938
Phone
(385) 399-8787
Fax
(385) 359-0808
NPI assigned
Mar 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 5, 2026

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

Authorized official

Name
Dr. Jeremy Easton Thueson, MDNPI 1902125032
Title
Manager
Phone
(385) 399-8787

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction Psychiatry PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 2084P0802X Primary

Addresses

Primary practice location

450 S 400 E Ste 501
Bountiful, UT 84010-4938

Mailing address

450 S 400 E Ste 501
Bountiful, UT 84010-4938
Phone (385) 399-8787

National Provider Directory

National Provider Directory

Locations

450 S 400 E
Ste 501
Bountiful, UT 84010
Phone (385) 399-8787

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1772668800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1772668800000",
    "number": "1720934615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "450 S 400 E STE 501",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104938",
            "telephone_number": "385-399-8787",
            "fax_number": "385-359-0808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 S 400 E STE 501",
            "city": "BOUNTIFUL",
            "state": "UT",
            "postal_code": "840104938",
            "telephone_number": "385-399-8787",
            "fax_number": "385-359-0808"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORGE PSYCHIATRY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-03-05",
        "last_updated": "2026-03-05",
        "certification_date": "2026-03-05",
        "status": "A",
        "authorized_official_last_name": "THUESON",
        "authorized_official_first_name": "JEREMY",
        "authorized_official_middle_name": "EASTON",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "385-399-8787",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2084P0802X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychiatry & Neurology, Addiction Psychiatry",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bountiful, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 5, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.