Organization Active NPI

Living Tree Urgent Care

  • Urgent Care Clinic/Center
  • Logan, UT
National Provider Identifier
1366112922
Registry record updated Jul 11, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
LIVING TREE URGENT CARE
Practice address
1635 N 200 E
Logan, UT 84341-1913
Phone
(435) 565-6043
Fax
(435) 220-2030
NPI assigned
Sep 15, 2021
Last updated
Jul 11, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
LIVING TREE MEDICAL GROUPAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 11, 2025

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

Authorized official

Name
Kris Coleman, CPC,CMA
Title
Medical Office Coordinator
Phone
(435) 770-2131

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Urgent Care Clinic/Center 261QU0200X NU Primary

Addresses

Primary practice location

1635 N 200 E
Logan, UT 84341-1913

Mailing address

1635 N 200 E
Logan, UT 84341-1913
Phone (435) 565-6043

Other practice location 1

1201 S Main St Ste 110
Logan, UT 84321-8504
Phone (435) 565-6043

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220513000348 UT Part B Supplier - Clinic/Group Practice 8921485954 Receives reassigned benefits from 6 practitioners
Practice locations: Logan, UT

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2246263Living Tree Urgent Care1201 S Main St, Ste 110, Logan, UT 84321Certificate of waiverDec 21, 2027

National Provider Directory

National Provider Directory
Part of
Living Tree Medical Group

Locations

169 N Gateway Dr
Ste 175
Providence, UT 84332
Phone (435) 565-6043

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 7

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": "1631664000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1366112922",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1635 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411913",
            "telephone_number": "435-565-6043"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1635 N 200 E",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843411913",
            "telephone_number": "435-565-6043",
            "fax_number": "435-220-2030"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1201 S Main St Ste 110",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "843218504",
            "country_code": "US",
            "telephone_number": "435-565-6043",
            "fax_number": "435-220-2030",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVING TREE URGENT CARE",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "LIVING TREE MEDICAL GROUP",
        "enumeration_date": "2021-09-15",
        "last_updated": "2025-07-11",
        "certification_date": "2025-07-11",
        "status": "A",
        "authorized_official_last_name": "COLEMAN",
        "authorized_official_first_name": "KRIS",
        "authorized_official_title_or_position": "MEDICAL OFFICE COORDINATOR",
        "authorized_official_telephone_number": "435-770-2131",
        "authorized_official_credential": "CPC,CMA"
    },
    "taxonomies": [
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 11, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.