NPIMap

Organization Active NPI

Eagle Mountain Family Medicine. LLC

Doing business as Crossroads Family Medicine

  • Family Medicine Physician
  • Saratoga Springs, UT
National Provider Identifier
1316012628
Registry record updated Jan 26, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
942752821205 Issued in UT
Legal business name
EAGLE MOUNTAIN FAMILY MEDICINE. LLC
Doing business as
Crossroads Family Medicine
Practice address
1305 N Commerce Dr
Suite 120
Saratoga Springs, UT 84045-5305
Phone
(801) 766-2121
Fax
(801) 768-2612
NPI assigned
Nov 21, 2006
Last updated
Jan 26, 2011By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 26, 2011

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

Authorized official

Name
Kenneth L Crump, MDNPI 1891719308
Title
Ceo
Phone
(801) 766-2121

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 942752821205 UT Primary

Addresses

Primary practice location

1305 N Commerce Dr
Suite 120
Saratoga Springs, UT 84045-5305

Mailing address

811 North 500 West
Orem, UT 84057-7701
Phone (801) 434-7600

Other names 1

  • Crossroads Family Medicine Doing business as

National Provider Directory

National Provider Directory

Locations

3688 E Campus Dr
Ste 200
Eagle Mtn, UT 84005
Phone (801) 789-5416

1305 N Commerce Dr
Ste 120
Saratoga Springs, UT 84045
Phone (385) 557-7657

Practitioners & affiliated clinicians

Practitioners 6

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.

NPI Registry JSON

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1296000000000",
    "number": "1316012628",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "811 NORTH 500 WEST",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840577701",
            "telephone_number": "801-434-7600",
            "fax_number": "801-434-7604"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1305 N COMMERCE DR",
            "address_2": "SUITE 120",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840455305",
            "telephone_number": "801-766-2121",
            "fax_number": "801-768-2612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "EAGLE MOUNTAIN FAMILY MEDICINE. LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2011-01-26",
        "status": "A",
        "authorized_official_last_name": "CRUMP",
        "authorized_official_first_name": "KENNETH",
        "authorized_official_middle_name": "L",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "801-766-2121",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "942752821205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Crossroads Family Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Saratoga Springs, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 26, 2011; 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.