Mountainstar Medical Group- Cache Valley, LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MOUNTAINSTAR MEDICAL GROUP- CACHE VALLEY, LLC

Doing business as

MountainStar Cache Valley Medical Group

Practice address

382 W 280 N
Providence, UT 84332-9753

Phone

(435) 752-0330

Fax

(435) 755-0922

NPI assigned

Nov 25, 2008

Last updated

Jan 2, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Louis Joseph

Title

VP

Phone

(615) 373-7630

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• MountainStar Cache Valley Medical Group Doing business as

Locations

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Thomas J Baker, PA-C

  • Physician Assistant
  • Farr West, UT
  • NPI 1245254739

  Family Medicine

  NPD (past)
• John M Hemmersmeier, MD

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1073582995
  NPD (past)
• Julia Anne Rothgery, MD

  • Family Medicine Physician
  • Farr West, UT
  • NPI 1609020072
  NPD (past)
• Hannah Beate Thomsen, NP

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1942789433

  Single Specialty

  NPD (past)

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

{
    "created_epoch": "1227571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1672617600000",
    "number": "1144475674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2000 HEALTH PARK DR",
            "city": "BRENTWOOD",
            "state": "TN",
            "postal_code": "370274525",
            "telephone_number": "615-373-7600",
            "fax_number": "866-346-1426"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "382 W 280 N",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329753",
            "telephone_number": "435-752-0330",
            "fax_number": "435-755-0922"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINSTAR MEDICAL GROUP- CACHE VALLEY, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-25",
        "last_updated": "2023-01-02",
        "certification_date": "2023-01-02",
        "status": "A",
        "authorized_official_last_name": "JOSEPH",
        "authorized_official_first_name": "LOUIS",
        "authorized_official_title_or_position": "VP",
        "authorized_official_telephone_number": "615-373-7630"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1144475674",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MountainStar Cache Valley Medical Group",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MountainStar Cache Valley Medical Group",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

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• Family Medicine Physician in Providence, UT
• Providers in Providence, UT by specialty
• Family Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 2, 2023; 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.