Glenn O Mortensen, MD

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

1609171205 Issued in UT

Practice address

1750 N 1000 E
Logan, UT 84341-1909

Phone

(435) 757-1516

NPI assigned

Aug 8, 2006

Last updated

Feb 19, 2016By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Medicine

State licenses

Practice roles

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.

• Ihc Health Services Inc

  dba South Cache Valley Clinic

  • Family Medicine Physician
  • Logan, UT
  • NPI 1982748737
  NPD (past)
• Ihc Health Services, Inc.

  dba St George Adolescent Partial Hospitalization

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD (past)
• Logan Urology Clinic

  • Exclusive Provider Organization
  • Logan, UT
  • NPI 1326274507
  NPD (past)

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

{
    "created_epoch": "1154995200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1455840000000",
    "number": "1184634669",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 N 1000 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411909",
            "telephone_number": "435-757-1516"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 N 1000 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411909",
            "telephone_number": "435-757-1516"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MORTENSEN",
        "first_name": "GLENN",
        "middle_name": "O",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-08-08",
        "last_updated": "2016-02-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "1609171205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kaydon James Morgan
• Carol Ann Morrell
• Natalie Mortensen Morrill
• Diane N Morris, LCSW
• Tod Michael Morrison, FNP
• Blake C. Mortenson, M.D.
• Francis Neal Mortenson, M.D.
• Timothy Mosher, DMD
• Jennifer Carter Mosteller, NP
• Mount Logan Clinic LLC

• Family Medicine Physician in Logan, UT
• Providers in Logan, 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 Feb 19, 2016; 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.