Organization Active NPI

Mountain West Medical Clinic

  • Primary Care Clinic/Center
  • South Jordan, UT
National Provider Identifier
1073475794
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Primary Care Clinic/CenterTaxonomy code 261QP2300X
Legal business name
MOUNTAIN WEST MEDICAL CLINIC
Practice address
922 W Baxter Dr Ste 110
South Jordan, UT 84095-8626
Phone
(385) 281-9846
NPI assigned
Dec 1, 2025
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Matthew Srithiemthong
Title
Ceo
Phone
(801) 603-4864

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X Primary

Addresses

Primary practice location

922 W Baxter Dr Ste 110
South Jordan, UT 84095-8626

Mailing address

922 W Baxter Dr Ste 110
South Jordan, UT 84095-8626
Phone (385) 281-9846

National Provider Directory

National Provider Directory

Locations

922 W Baxter Dr
Ste 110
South Jordan, UT 84095
Phone (385) 281-9846

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1764547200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1073475794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "922 W BAXTER DR STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958626",
            "telephone_number": "385-281-9846"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "922 W BAXTER DR STE 110",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840958626",
            "telephone_number": "385-281-9846"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN WEST MEDICAL CLINIC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-12-01",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "SRITHIEMTHONG",
        "authorized_official_first_name": "MATTHEW",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-603-4864"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.