NPIMap

Individual provider Active NPI

Colten Dirk Bracken, M.D.

  • Family Medicine Physician
  • Enterprise, UT
National Provider Identifier
1073993283
Registry record updated Oct 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
9832788-1205 Issued in UT
Practice address
571 East Main Street
Enterprise, UT 84725
Phone
(435) 878-5711
Fax
(435) 878-5712
NPI assigned
Jun 2, 2015
Last updated
Oct 28, 2025By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X 9832788-1205 UT Primary

Addresses

Primary practice location

571 East Main Street
Enterprise, UT 84725

Mailing address

1055 N 500 W
Provo, UT 84604-3305
Phone (801) 354-8225

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, NV2 enrollments
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
I20160914001810 UT Practitioner - Family Practice 6709172968 Reassigns benefits to 4 organizations
I20250421001582 NV Practitioner - Emergency Medicine 6709172968 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Family Practice
Education
Mayo Medical School, 2015
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Revere Health PCGroup PAC ID 7517868508, 407 clinicians
Lincoln County Hospital DistrictGroup PAC ID 2163408246, 11 clinicians

Practice addresses (Care Compare)

571 E Main St
Enterprise, UT 84725
Phone (435) 878-5711

571 E Main St
Enterprise, UT 84725-0070
Phone (435) 878-5711

700 N Spring St
Caliente, NV 89008-1010
Phone 7757263171012

Hospital & facility affiliations

Procedures performed for Medicare patients

ProcedureNumber of procedures
Melanoma (skin cancer) excision1-10
Removal of skin lesions1-10
Removal or shaving of skin growth1-10
Skin biopsy1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Aug 1, 2016 Accepting new patients
Revere Health PC CurrentSince Dec 1, 2025 Accepting new patients
Ihc Health Services Inc CurrentSince Jul 1, 2017 Accepting new patients
Ihc Health Services Inc CurrentSince Aug 1, 2016 Accepting new patients
Main Street Family Medicine PLLC Family Medicine CurrentSince Oct 5, 2020 Accepting new patients
Ihc Health Services Inc Family Medicine Current Accepting new patients
Lincoln County Hospital District CurrentSince Apr 10, 2025 Accepting new patients
Lincoln County Hospital District CurrentSince Apr 10, 2025 Accepting new patients
Revere Health PC CurrentSince Dec 1, 2025 Accepting new patients
Ihc Health Services Inc Current Accepting new patients
Lincoln County Hospital District Past Accepting new patients

Locations

700 S Highway 99
Ste 3
Fillmore, UT 84631
Phone (435) 743-5555

1055 N 500 W
Provo, UT 84604
Phone (801) 429-8000

1000 N Main St
Richfield, UT 84701
Phone (435) 893-4100

1380 E Medical Center Dr
St George, UT 84790
Phone (435) 251-2992

Networks

  • UT PPO D-SNP
  • UT PPO

Interoperability endpoints

  • Direct secure messaging: colten.bracken.1@23119.direct.athenahealth.com
  • Direct secure messaging: coltenbracken@cuccu.allscriptsdirect.net
  • FHIR API: https://api.platform.athenahealth.com/23119/brand/1/csg/1/fhir/r4

Ownership & related parties

All facility ownership & control disclosures 1

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Main Street Family Medicine PLLCEnterprise, UT, CCN 463822 Rural health clinic 5% Or Greater Direct Ownership Interest (100%)
Corporate Director (100%)
W-2 Managing Employee (100%)		 Oct 5, 2020
Oct 5, 2020
Oct 5, 2020

Owned or controlled facilities with NPI records 1

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Organizations & group practices 11

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

Hospital & facility affiliations 7

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1433203200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1761609600000",
    "number": "1073993283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1055 N 500 W",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043305",
            "telephone_number": "801-354-8225",
            "fax_number": "801-377-5757"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "571 EAST MAIN STREET",
            "city": "ENTERPRISE",
            "state": "UT",
            "postal_code": "84725",
            "telephone_number": "435-878-5711",
            "fax_number": "435-878-5712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BRACKEN",
        "first_name": "COLTEN",
        "middle_name": "DIRK",
        "credential": "M.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2015-06-02",
        "last_updated": "2025-10-28",
        "certification_date": "2025-10-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "9832788-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Enterprise, UT

Sources for this page

Verify at the official NPI Registry.