Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Dr. Shane Michael Hawthorne, MD

Individual provider Family Medicine Physician · NPI 1629462189

Dr. Shane Michael Hawthorne, MD is a Family Practice in Orem, Utah. Graduated from University of Utah School of Medicine in 2015, 11 years ago. Practices with Premier Family Medical, a 84-clinician group, accepts Medicare assignment and offers telehealth. Licensed in Utah.

Years since qualifying
11
Trained at
University of Utah School of Medicine
Licensed in
UT
In the registry since
2015
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

155 W 400 N
Orem, UT 84057-4658
Phone: (801) 224-1300
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Family Medicine Physician (primary) Taxonomy 207Q00000X · Licence 5450642-1205 (UT)

Record details

NPI number1629462189
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorNo
NPI enumeratedMarch 23, 2015
Last updated in NPPESAugust 6, 2019

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF UTAH SCHOOL OF MEDICINE
Graduated 2015 (11 years in practice)
Group practice Premier Family Medical — 84 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations5 on file with Medicare

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