Individual provider Active NPI

David C Thorson, MD

  • Family Medicine Physician
  • Woodbury, MN
National Provider Identifier
1972510634
Registry record updated Mar 7, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
30312 Issued in MN
Practice address
731 Bielenberg Dr
Suite 107
Woodbury, MN 55125
Phone
(612) 865-4686
Fax
(651) 730-7772
NPI assigned
Aug 2, 2006
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 7, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 30312 MN Primary

Addresses

Primary practice location

731 Bielenberg Dr
Suite 107
Woodbury, MN 55125

Mailing address

731 Bielenberg Dr
Suite 107
Woodbury, MN 55125
Phone (612) 865-4686

Other identifiers 1

IdentifierTypeStateIssuer
328288100MedicaidMN

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20071217000490 MN Practitioner - Family Practice 7517870132 Reassigns benefits to 1 organization

National Provider Directory

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

Practice roles

OrganizationSpecialtyStatusNew patients
United Family Practice Health Center Family Medicine CurrentSince Aug 9, 2019 Accepting new patients
United Family Practice Health Center Family Medicine Current Accepting new patients
Kinetic Physical Therapy Institute CurrentSince Dec 6, 2022 Accepting new patients

Locations

1026 7th St W
Saint Paul, MN 55102
Phone (651) 241-1000

731 Bielenberg Dr
Ste 107
Woodbury, MN 55125
Phone (651) 730-7771

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
United Family MedicineSaint Paul, MN, CCN 241829 Federally qualified health center Corporate Officer
W-2 Managing Employee
May 15, 2023
May 15, 2023

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 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1154476800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678147200000",
    "number": "1972510634",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 107",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "612-865-4686",
            "fax_number": "651-730-7772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "731 BIELENBERG DR",
            "address_2": "SUITE 107",
            "city": "WOODBURY",
            "state": "MN",
            "postal_code": "55125",
            "telephone_number": "612-865-4686",
            "fax_number": "651-730-7772"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "THORSON",
        "first_name": "DAVID",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "MD",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-02",
        "last_updated": "2023-03-07",
        "certification_date": "2022-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "MN",
            "license": "30312",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "328288100",
            "state": "MN"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodbury, MN

Sources for this page

Verify at the official NPI Registry.