Active NPI
Nicole Lee Thorsen, CNM
- Advanced Practice Midwife
- Park City, UT
National Provider Identifier
1992253199
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Advanced Practice Midwife
- License
- 7484374-4402
- Practice address
- 900 Round Valley Dr
Park City, UT 84060-7552 - Phone
- (435) 658-7264
- NPI assigned
- Sep 15, 2016
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Advanced Practice Midwife | 367A00000X | 7484374-4402 | UT | Primary |
Addresses
Primary practice location
900 Round Valley Dr
Park City, UT 84060-7552
Mailing address
751 E Valley Dr
Heber City, UT 84032-1059
Phone (435) 565-0659
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Certified Nurse Midwife
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7484374-4402 | UT | MD | Advanced Practice Midwife |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1473897600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1473897600000",
"number": "1992253199",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "751 E VALLEY DR",
"city": "HEBER CITY",
"state": "UT",
"postal_code": "840321059",
"telephone_number": "435-565-0659"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "900 ROUND VALLEY DR",
"city": "PARK CITY",
"state": "UT",
"postal_code": "840607552",
"telephone_number": "435-658-7264"
}
],
"practiceLocations": [],
"basic": {
"last_name": "THORSEN",
"first_name": "NICOLE",
"middle_name": "LEE",
"credential": "CNM",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2016-09-15",
"last_updated": "2016-09-15",
"status": "A"
},
"taxonomies": [
{
"code": "367A00000X",
"taxonomy_group": "",
"desc": "Advanced Practice Midwife",
"state": "UT",
"license": "7484374-4402",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Park City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 15, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.