Castleview Physician Practice, LLC
Organization Active NPI Family Medicine Physician · Price, UT
NPI 1326569245 · NPPES record last updated Jun 30, 2017
Key facts
- NPI
- 1326569245
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- CASTLEVIEW PHYSICIAN PRACTICE, LLC
- Practice address
- 317 East 100 North
Price, UT 84501 - Phone
- (435) 637-5061
- Fax
- (435) 637-1899
- NPI assigned
- Jun 30, 2017
- Organization subpart
- No
Authorized official
- Name
- Sara Miller
- Title
- Director
- Phone
- (615) 920-7514
Other NPIs on the same Medicare enrollment 16
Corporate family (same tax ID) 11
Practitioners 4
-
Mackenzie Burger, MD
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D2135277 | Castleview Urgent Care | Certificate of waiver | Aug 16, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20090518000607 | UT | Part B Supplier - Clinic/Group Practice | 6305995598 |
Receives reassigned benefits from 37 practitioners 16 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Price, UT; Castle Dale, UT |
National Provider Directory
- Tax ID family
- Castleview Physician Practice LLC
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes | ||
| Internal Medicine Physician |
207R00000X |
Addresses
Primary practice location
317 East 100 North
Price, UT 84501
Mailing address
330 Seven Springs Way
Brentwood, TN 37027-5098
Phone (615) 920-7000
Other names
- Castleview Urgent Care
Other providers in Price, UT
- Castleview Hospital, LLC
- Castleview Hospital, LLC
- Castleview Hospital, LLC
- Castleview Physician Practice LLC
- Castleview Physician Practice, LLC
- Castleview Physician Practice, LLC
- Castleview Physician Practice, LLC
- Castleview Physician Practice, LLC
- Castleview Physician Practices LLC
- Castleview Physician Practices LLC
All providers in Price, 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 Jun 30, 2017. 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.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.