NPIMap

Individual provider Active NPI

Nicholas Thomson, M.D.

  • Hematology & Oncology Physician
  • American Fork, UT
National Provider Identifier
1891106936
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hematology & Oncology PhysicianTaxonomy code 207RH0003X
License
11701324-1205 Issued in UT
Practice address
1152 E 200 N
American Fork, UT 84003-2004
Phone
(801) 772-0698
Fax
(801) 772-0705
NPI assigned
May 12, 2014
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X R74328 AZ
Hematology & Oncology Physician 207RH0003X 11701324-1205 UT Primary

Addresses

Primary practice location

1152 E 200 N
American Fork, UT 84003-2004

Mailing address

1055 N 500 W
Provo, UT 84604-3305
Phone (801) 429-8000

Electronic endpoints 2

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com
Other URL RevereHealth.com

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, MT2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20200716003541 UT Practitioner - Hematology/OncologyPractitioner - Internal Medicine 3274810197 Reassigns benefits to 1 organization
I20241008002645 MT Practitioner - Hematology/Oncology 3274810197 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Hematology/Oncology
Education
University of Arizona College of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians

Practice addresses (Care Compare)

1055 N 500
Provo, UT 84604-3305
Phone (801) 374-2367

Hospital & facility affiliations

  • Cascade Springs Hospice Hospice, Clearfield, UT, CCN 461608
  • Harmony Hospice Hospice, Murray, UT, CCN 461519
  • Utah Hospice Hospice, Orem, UT, CCN 461590
  • Intermountain Health Utah Valley Hospital Hospital, Provo, UT, CCN 460001
  • American Fork Hospital Hospital, American Fork, UT, CCN 460023
  • St Peters Health Hospital, Helena, MT, CCN 270003
  • Mountain West Medical Center Hospital, Tooele, UT, CCN 460014

National Provider Directory

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

State licenses

LicenseStateTypeSpecialty
R74328AZMDInternal Medicine Physician
11701324-1205UTMDHematology & Oncology Physician

Practice roles

OrganizationSpecialtyStatusNew patients
St Peter'S Medical Group North CurrentSince Sep 16, 2024 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2020 Accepting new patients
Revere Health PC CurrentSince Jul 1, 2020 Accepting new patients
St. Peter'S Health CurrentSince Sep 16, 2024 Accepting new patients
St Peter'S Health Current Accepting new patients
St Peters Hospital Past Accepting new patients

Locations

2475 E Broadway St
Helena, MT 59601
Phone (406) 442-2480

1152 E 200 N
American Fork, UT 84003
Phone (801) 772-0698

1175 E 50 S
Ste 170
American Fork, UT 84003

1175 E 50 S
American Fork, UT 84003
Phone (719) 492-5994

1175 E 50 S
Ste 171
American Fork, UT 84003
Phone (801) 772-0698

1020 S 1100 W
Ste B
Lehi, UT 84043
Phone (801) 653-2757

1055 N 500 W
Ste 212
Provo, UT 84604
Phone (801) 374-2362

1055 N 500 W
Ste 202
Provo, UT 84604
Phone (801) 374-2367

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

Interoperability endpoints

  • Direct secure messaging: nicholasthomson@cuccu.allscriptsdirect.net

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Harmony HospiceMurray, UT, CCN 461519 Hospice Contracted Managing Employee Jun 13, 2024

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 6

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 12

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": "1399852800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1891106936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-429-8000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1152 E 200 N",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032004",
            "telephone_number": "801-772-0698",
            "fax_number": "801-772-0705"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THOMSON",
        "first_name": "NICHOLAS",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2014-05-12",
        "last_updated": "2023-11-27",
        "certification_date": "2020-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "AZ",
            "license": "R74328",
            "primary": false
        },
        {
            "code": "207RH0003X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hematology & Oncology",
            "state": "UT",
            "license": "11701324-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "address_1": "1152 E 200 N",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032004",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "RevereHealth.com",
            "affiliation": "N",
            "address_1": "1152 E 200 N",
            "city": "American Fork",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840032004",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

Verify at the official NPI Registry.