Shannon Taylor Thurston, PA-C

Primary specialty

Medical Physician AssistantTaxonomy code 363AM0700X

License

7154120-1206 Issued in UT

Practice address

585 West Main Street
Green River, UT 84525

Phone

(435) 564-3434

Fax

(435) 564-3214

NPI assigned

Nov 20, 2008

Last updated

Feb 5, 2024By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Green River Medical Center Inc

  dba Two Rivers Community Health

  • Federally Qualified Health Center (FQHC)
  • Green River, UT
  • NPI 1942317722
  Medicare reassignment
• Innovation Medical Group PC

  dba Innovation Medical Group

  • Podiatrist
  • Salt Lake City, UT
  • NPI 1235526682
  Medicare reassignment
• Wayne Community Health Centers Inc

  • Federally Qualified Health Center (FQHC)
  • Bicknell, UT
  • NPI 1093816282
  Medicare reassignment
• Wayne Community Health Centers Inc

  dba Kazan Ivan W Memorial Clinic

  • Federally Qualified Health Center (FQHC)
  • Escalante, UT
  • NPI 1568886000
  NPD
• Wayne Community Health Centers, Inc

  dba Salina Family Medicine Clinic

  • Federally Qualified Health Center (FQHC)
  • Salina, UT
  • NPI 1659979193
  NPD
• Taylor G Wright PC

  dba Innovation Medical Group

  • Podiatrist
  • Layton, UT
  • NPI 1528765575
  NPD (past)
• Taylor G Wright PC

  dba Innovation Medical Group

  • Podiatrist
  • Provo, UT
  • NPI 1972298628
  NPD (past)

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

{
    "created_epoch": "1227139200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1707091200000",
    "number": "1821243684",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6405 S 3000 E STE 300",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841216977",
            "telephone_number": "801-266-3113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "585 WEST MAIN STREET",
            "city": "GREEN RIVER",
            "state": "UT",
            "postal_code": "84525",
            "telephone_number": "435-564-3434",
            "fax_number": "435-564-3214"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3152 N University Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846044746",
            "country_code": "US",
            "telephone_number": "801-900-5655",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "3152 N University Ave Ste 240",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84604",
            "country_code": "US",
            "telephone_number": "801-900-5655",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "SHANNON",
        "middle_name": "TAYLOR",
        "name_prefix": "Mrs.",
        "credential": "PA-C",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-11-20",
        "last_updated": "2024-02-05",
        "certification_date": "2024-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AM0700X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Medical",
            "state": "UT",
            "license": "7154120-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Green River Medical Center, Inc. (Green River Medical Center Pharmacy)
• Brouquelyn Mia Hatfield-Knight, RDH BSDH
• Kim Thyrill McFarlane, MPAS, PA-C
• Tyler J Rundell, PA-C
• Zackery N Taylor, PHARMD/MBA
• Dallin Trout
• Loye West, PA-C
• Reagan M Whiteleather, RDH

• Medical Physician Assistant in Green River, UT
• Providers in Green River, UT by specialty
• Medical Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 5, 2024; 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.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.