NPIMap

Organization Active NPI

Beaver Medical, LLC

Doing business as Beaver/Milford Medical Clinic

  • Rural Health Clinic/Center
  • Milford, UT
National Provider Identifier
1336136969
Registry record updated Feb 18, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
BEAVER MEDICAL, LLC
Doing business as
Beaver/Milford Medical Clinic
Practice address
850 N Main
Milford, UT 84751-0640
Phone
(435) 387-2471
Fax
(435) 387-2475
NPI assigned
Sep 29, 2005
Last updated
Feb 18, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2026

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

Authorized official

Name
Julie Christensen
Title
Office Manager
Phone
(435) 438-7280

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Primary Care Clinic/Center 261QP2300X
Rural Health Clinic/Center 261QR1300X Primary

Addresses

Primary practice location

850 N Main
Milford, UT 84751-0640

Mailing address

PO Box 1690
Beaver, UT 84713-1690
Phone (435) 438-7280

Other identifiers 1

IdentifierTypeStateIssuer
CG2421OtherRAILROAD MEDICARE PALMETTO

Other names 1

  • Beaver/Milford Medical Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20030710000010 UT Part A Provider - Rural Health Clinic 2365352036 Practice locations: Milford, UT
O20050714000791 UT Part B Supplier - Clinic/Group Practice 2365352036 Receives reassigned benefits from 11 practitioners
1 other NPI on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Milford, UT; Beaver, UT; Parowan, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1336136969. Details of each certification follow.

Rural health clinic certification: CCN 463991

Legal name
BEAVER MEDICAL, LLC
Doing business as
BEAVER/ MILFORD MEDICAL CLINIC
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Aug 27, 2003
Last certification
Sep 19, 2017
Ownership / control type
1C
Organization structure
LLCProprietary
Incorporated
Feb 25, 2000 in UT
Enrollment address
850 N Main
Milford, UT 84751-0640
Related CCNs
461305

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 2

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Beaver Medical Clinic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

Organizations that report the same tax identification number in the National Provider Directory.

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/1689f559-34cb-4d05-ae6b-0d5c8a6ea89c/

Ownership & related parties

All disclosed owners & managing parties 4

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Lance C Smith Individual 5% Or Greater Direct Ownership Interest Jan 1, 2010 33%
Rhett Roger Smith Individual 5% Or Greater Direct Ownership Interest Aug 23, 2018 33%
Julie Christensen Individual W-2 Managing Employee Jan 7, 2013
Richard Wade Oakden Individual 5% Or Greater Direct Ownership Interest Aug 1, 2003 33%

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

NPI Registry JSON

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

{
    "created_epoch": "1127952000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1771372800000",
    "number": "1336136969",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 1690",
            "city": "BEAVER",
            "state": "UT",
            "postal_code": "847131690",
            "telephone_number": "435-438-7280",
            "fax_number": "435-438-7210"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "850 N MAIN",
            "city": "MILFORD",
            "state": "UT",
            "postal_code": "847510640",
            "telephone_number": "435-387-2471",
            "fax_number": "435-387-2475"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BEAVER MEDICAL, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2005-09-29",
        "last_updated": "2026-02-18",
        "certification_date": "2026-02-18",
        "status": "A",
        "authorized_official_last_name": "CHRISTENSEN",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "OFFICE MANAGER",
        "authorized_official_telephone_number": "435-438-7280"
    },
    "taxonomies": [
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE PALMETTO",
            "identifier": "CG2421",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Beaver/Milford Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Milford, UT

Sources for this page

Verify at the official NPI Registry.