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

Jonathan Keith Nielsen, MD

Individual provider Family Medicine Physician · NPI 1477312957

Jonathan Keith Nielsen, MD is a Family Practice in Provo, Utah. Graduated from University of Texas Medical Branch at Galveston in 2024, 2 years ago. Practices as a sole proprietor. Licensed in Utah.

Years since qualifying
2
Trained at
University of Texas Medical Branch at Galveston
Licensed in
UT
In the registry since
2024
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

395 W Cougar Blvd Ste 205
Provo, UT 84604-3328
Phone: (801) 357-1770
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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 14237093-1205 (UT)

Record details

NPI number1477312957
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 18, 2024
Last updated in NPPESNovember 12, 2025
Certification dateNovember 12, 2025
Mailing addressPo Box 27128, Salt Lake City, UT 84127-0128

Medicare enrollment

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

Medicare specialtyFAMILY PRACTICE
Medical schoolUNIVERSITY OF TEXAS MEDICAL BRANCH AT GALVESTON
Graduated 2024 (2 years in practice)
Accepts Medicare assignment Not indicated
Practice locations2 on file with Medicare

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