NPIMap

Organization Active NPI

Corner Clinic St George LLC

  • Family Medicine Physician
  • St George, UT
National Provider Identifier
1629568209
Registry record updated Aug 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
CORNER CLINIC ST GEORGE LLC
Practice address
2351 S River Rd Unit 5
St George, UT 84790-8280
Phone
(435) 659-7352
NPI assigned
May 18, 2018
Last updated
Aug 5, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 5, 2022

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

Authorized official

Name
Shane Whittier
Title
Coo
Phone
(435) 709-8786

Specialties & licenses 1

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

Addresses

Primary practice location

2351 S River Rd Unit 5
St George, UT 84790-8280

Mailing address

2351 S River Rd Unit 5
St George, UT 84790-8280
Phone (435) 659-7352

Other practice location 1

1930 W Sunset Blvd Ste 94
St George, UT 84770-6792
Phone (435) 709-8786

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL www.cornerclinic.com

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20220321002050 UT Part B Supplier - Clinic/Group Practice 6406241835 Receives reassigned benefits from 12 practitioners
Practice locations: St George, 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
46D2146494Corner Clinic St George, LLC2351 S River Rd, St George, UT 84790Provider-performed microscopyMar 28, 2028

National Provider Directory

National Provider Directory

Locations

2351 S River Rd
St George, UT 84790
Phone (435) 709-8786

Practitioners & affiliated clinicians

Practitioners 17

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.

View all 17

NPI Registry JSON

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

{
    "created_epoch": "1526601600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1659657600000",
    "number": "1629568209",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2351 S RIVER RD UNIT 5",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908280",
            "telephone_number": "435-659-7352"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2351 S RIVER RD UNIT 5",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847908280",
            "telephone_number": "435-659-7352"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1930 W Sunset Blvd Ste 94",
            "address_purpose": "LOCATION",
            "city": "St George",
            "state": "UT",
            "postal_code": "847706792",
            "country_code": "US",
            "telephone_number": "435-709-8786",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "CORNER CLINIC ST GEORGE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-05-18",
        "last_updated": "2022-08-05",
        "certification_date": "2022-08-05",
        "status": "A",
        "authorized_official_last_name": "WHITTIER",
        "authorized_official_first_name": "SHANE",
        "authorized_official_title_or_position": "COO",
        "authorized_official_telephone_number": "435-709-8786"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "www.cornerclinic.com",
            "affiliation": "N",
            "address_1": "2351 S River Rd Unit 5",
            "city": "St George",
            "state": "UT",
            "country_code": "US",
            "postal_code": "847908280",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2022; 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.