Concord Premium Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

3713101205 Issued in UT

Legal business name

CONCORD PREMIUM GROUP

Practice address

356 N 750 W
Ste D9-213
American Fork, UT 84003-1678

Phone

(801) 300-5159

NPI assigned

Sep 24, 2009

Organization subpart

No

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

Authorized official

Name

Daniel W Thompson

Title

Ceo

Phone

(801) 300-5159

Specialties & licenses 1

Addresses

Locations

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

{
    "created_epoch": "1253750400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1255651200000",
    "number": "1255665162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "356 N 750 W",
            "address_2": "STE D9-213",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031678"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "356 N 750 W",
            "address_2": "STE D9-213",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840031678",
            "telephone_number": "801-300-5159"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONCORD PREMIUM GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-09-24",
        "last_updated": "2009-10-16",
        "status": "A",
        "authorized_official_last_name": "THOMPSON",
        "authorized_official_first_name": "DANIEL",
        "authorized_official_middle_name": "W",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-300-5159"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "3713101205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Vilate Coleman
• Daniel B Coles, DDS, FAGD
• Sarah Coles
• Fazli Collaku, PHARM. D.
• Gabriel Coltrin
• Marsena E Conner, M.D.
• Consolation, Inc.
• Brooke Cook
• Emily Cook
• Joseph Vernon Cook Jr., MD

• Family Medicine Physician in American Fork, UT
• Providers in American Fork, 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 Oct 16, 2009; 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.