MOUNTAIN PEAKS FAMILY PRACTICE LC NPI 1023263969

NPI Information

NPI: 1023263969
Provider Name: MOUNTAIN PEAKS FAMILY PRACTICE LC
Classification: Clinic/Center - 261QH0100X
Entity Type: Organization

Specialization: Health Service

CLIA Number: 46D0928175

Address:
501 E 770 N
OREM, UT
ZIP 84097
Phone: (801) 724-9840
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MOUNTAIN PEAKS FAMILY PRACTICE LC is a health service clinic center in Orem, UT. MOUNTAIN PEAKS FAMILY PRACTICE LC NPI is 1023263969. The provider is registered as an organization entity type.

The provider's business location address is:

501 E 770 N
OREM, UT
ZIP 84097-102
Phone: (801) 724-9840

The provider's authorized official is Robert Guy Durrans .
The authorized official title is Owner/partner and has the following contact phone number (801) 724-9840.

The CLIA number assigned to this NPI record is 46D0928175 - community clinic with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 11/19/2008 and was last updated on 12/22/2015.

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 Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	261QH0100X	Clinic/Center	Health Service			Yes

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 Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	1447332465	MEDICAID	UTAH

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

NPI Synchronization or Removal

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