Stellar PCP LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

STELLAR PCP LLC

Doing business as

Ovation Primary Care

Practice address

800 E Fort Union Blvd Ste B
Midvale, UT 84047-2391

Phone

(801) 694-1198

NPI assigned

Mar 10, 2023

Last updated

Dec 20, 2024By 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

Mathew Harrison

Title

Cfo

Phone

(817) 941-1068

Specialties & licenses 1

Addresses

Other names 1

• Ovation Primary Care Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734652800000",
    "number": "1144921867",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 E FORT UNION BLVD STE B",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472391",
            "telephone_number": "801-694-1198"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "800 E FORT UNION BLVD STE B",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472391",
            "telephone_number": "801-694-1198"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STELLAR PCP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A",
        "authorized_official_last_name": "HARRISON",
        "authorized_official_first_name": "MATHEW",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "817-941-1068"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Ovation Primary Care",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Ovation Primary Care",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael Stapley, PHARMD
• Tori Joy Steely
• Glen Steenblik, LCSW
• Daina R Steffensen, CASE MANAGER
• Stellar Hospice Salt Lake LLC (Ovation Hospice of Salt Lake)
• Angela M Stephany
• Kirk Ronald Stephens, PA-C
• Hailee Stewart
• Debra Lynn Stone, ACNP-BC
• Rosalie Stone, OT

• Family Medicine Physician in Midvale, UT
• Providers in Midvale, 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 Dec 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.