Individual provider Active NPI

Ryan Paul Thurston, DNP, FNP

  • Nurse Practitioner
  • Salem, UT
National Provider Identifier
1932752615
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Nurse PractitionerTaxonomy code 363L00000X
License
9415652-4405 Issued in UT
Practice address
555 West Sr 164
Salem, UT 84653
Phone
(801) 465-4813
Fax
(801) 812-5433
NPI assigned
Jul 22, 2019
Last updated
Nov 27, 2023By the provider in NPPES
Sex
Male
Sole proprietor
Yes

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Nurse Practitioner 363L00000X 9415652-4405 UT Primary

Addresses

Primary practice location

555 West Sr 164
Salem, UT 84653

Mailing address

1055 N 500 W
Attn. Credentialing
Provo, UT 84604
Phone (801) 354-8225

Other practice location 1

972 N 600 E
Spanish Fork, UT 84660-1306
Phone (801) 465-4896

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address medreview@reverehealth.com Revere Health PC

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
I20190903001466 UT Practitioner - Nurse Practitioner 6305175266 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Nurse Practitioner
Education
University of Utah School of Medicine, 2019
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) 812-5033

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Nurse Practitioner

Practice roles

OrganizationSpecialtyStatusNew patients
Revere Health PC CurrentSince Jul 22, 2019 Accepting new patients
Revere Health PC CurrentSince Jul 22, 2019 Accepting new patients

Locations

3714 E Campus Dr
Ste 102
Eagle Mountain, UT 84005
Phone (385) 203-1365

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

1055 N 500 W
Bldg A
Provo, UT 84604
Phone (801) 418-0800

1055 N 500 W
Ste 200
Provo, UT 84604

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

555 W State Road 164
Salem, UT 84653
Phone (801) 465-4896

264 W 100 S
Santaquin, UT 84655
Phone (385) 203-1250

972 N 600 E
Spanish Fork, UT 84660
Phone (385) 265-6060

1930 W Sunset Blvd
Ste 94
St George, UT 84770
Phone (435) 375-0140

Interoperability endpoints

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

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1563753600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1932752615",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "address_2": "ATTN. CREDENTIALING",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "84604",
            "telephone_number": "801-354-8225",
            "fax_number": "801-418-0941"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 WEST SR 164",
            "city": "SALEM",
            "state": "UT",
            "postal_code": "84653",
            "telephone_number": "801-465-4813",
            "fax_number": "801-812-5433"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "972 N 600 E",
            "address_purpose": "LOCATION",
            "city": "Spanish Fork",
            "state": "UT",
            "postal_code": "846601306",
            "country_code": "US",
            "telephone_number": "801-465-4896",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "THURSTON",
        "first_name": "RYAN",
        "middle_name": "PAUL",
        "credential": "DNP, FNP",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2019-07-22",
        "last_updated": "2023-11-27",
        "certification_date": "2020-02-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363L00000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner",
            "state": "UT",
            "license": "9415652-4405",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "medreview@reverehealth.com",
            "affiliation": "Y",
            "affiliationName": "Revere Health PC",
            "address_1": "555 West SR 164",
            "city": "Salem",
            "state": "UT",
            "country_code": "US",
            "postal_code": "84653",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Salem, UT

Sources for this page

Verify at the official NPI Registry.