Canyon View Medical Group LLC
Organization Active NPI Family Medicine Physician · Santaquin, UT
NPI 1164580890 · NPPES record last updated Mar 16, 2023
Key facts
- NPI
- 1164580890
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CANYON VIEW MEDICAL GROUP LLC
- Practice address
- 94 W Main St
Santaquin, UT 84655 - Phone
- (801) 754-3122
- Fax
- (801) 754-0197
- NPI assigned
- Dec 5, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Aaron Lowe
- Title
- Administrator
- Phone
- (801) 798-7301
Other NPIs on the same Medicare enrollment 12
Practitioners 4
-
Tonya Coates, NP-C
-
Michael Dahl, PA
-
Susan Greer, FNP
-
Steven R Weatherspoon, D.O.
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031205000226 | UT | Part B Supplier - Clinic/Group Practice | 9739084351 |
Receives reassigned benefits from 33 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Salem, UT; Santaquin, UT; Spanish Fork, UT; Springville, UT; Mapleton, UT |
National Provider Directory
Locations
591 N State Road 198
Ste 203
Salem, UT 84653
Phone (801) 465-9802
94 W Main St
Santaquin, UT 84655
Phone (801) 754-3122
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
94 W Main St
Santaquin, UT 84655
Mailing address
325 W Center St
Spanish Fork, UT 84660-2060
Phone (801) 798-7301
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| CE7334 | Other | UT | RAIL ROAD MEDICARE |
Other names
- Santaquin Medical C linic
Other providers in Santaquin, UT
- Jared L Bingham
- Holly Binks
- Wesley S Bott
- Irina M. Campbell
- Canyon View Medical Group
- Jon Ralph Chisholm
- Joshua Richard Chisholm
- Nathan Richard Christensen
- Jessica Clegg
- Tonya Coates
All providers in Santaquin, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 16, 2023. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.