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MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER LLC NPI 1356588008


NPI Information

NPI: 1356588008
Provider Name: MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC

Former Legal Business Name: MOUNTAINSTAR PRIMARY CARE, LLC

Classification: Internal Medicine - 207R00000X
Entity Type: Organization

CLIA Number: 46D2002521

Address:
5405 S 500 E
STE. 100
OGDEN, UT
ZIP 84405
Phone: (801) 282-5952
Get Directions

MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC is an internal medicine in Ogden, UT. The provider is a physician who provides long-term, comprehensive care in the office and the hospital, managing both common and complex illness of adolescents, adults and the elderly. Internists are trained in the diagnosis and treatment of cancer, infections and diseases affecting the heart, blood, kidneys, joints and digestive, respiratory and vascular systems. They are also trained in the essentials of primary care internal medicine, which incorporates an understanding of disease prevention, wellness, substance abuse, mental health and effective treatment of common problems of the eyes, ears, skin, nervous system and reproductive organs. MOUNTAINSTAR MEDICAL GROUP-OGDEN REGIONAL MEDICAL CENTER, LLC NPI is 1356588008. The provider is registered as an organization entity type and is a multi-specialty group.
The provider Former Legal Business Name Is Mountainstar Primary Care, Llc.

The provider's business location address is:

5405 S 500 E
STE. 100
OGDEN, UT
ZIP 84405-957
Phone: (801) 282-5952
Fax: (801) 569-5990

The provider's authorized official is Louis Joseph .
The authorized official title is Vp and has the following contact phone number (615) 373-7630.

The CLIA number assigned to this NPI record is 46D2002521 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 1/17/2009 and was last updated on 8/29/2023.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207R00000XInternal MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
11356588008MEDICAIDUTAH

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.