NPIMap

Organization Active NPI

Sterling Provider Group

  • Urgent Care Clinic/Center
  • Logan, UT
National Provider Identifier
1639713589
Registry record updated Jun 17, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
STERLING PROVIDER GROUP
Practice address
630 E 1400 N Ste 150
Logan, UT 84341-2549
Phone
(435) 915-4465
Fax
(435) 799-3664
NPI assigned
Nov 4, 2019
Last updated
Jun 17, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 17, 2026

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

Authorized official

Name
Corbin Bunnage, PA-CNPI 1447325485
Title
Provider/Ower
Phone
(208) 542-9111

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X
Primary Care Clinic/Center 261QP2300X
Urgent Care Clinic/Center 261QU0200X Primary
Occupational Medicine Clinic/Center 261QX0100X

Addresses

Primary practice location

630 E 1400 N Ste 150
Logan, UT 84341-2549

Mailing address

740 S Woodruff Ave
Idaho Falls, ID 83401-5285
Phone (208) 542-9111

Other identifiers 1

IdentifierTypeStateIssuer
46D2147193OtherUTCLIA

National Provider Directory

National Provider Directory
Tax ID family
Sterling Provider Group19 organizations share this tax ID, including this one

Other organizations with this tax ID 18

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

View all 18

Practitioners & affiliated clinicians

Practitioners 1

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": "1572825600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1781654400000",
    "number": "1639713589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "740 S WOODRUFF AVE",
            "city": "IDAHO FALLS",
            "state": "ID",
            "postal_code": "834015285",
            "telephone_number": "208-542-9111",
            "fax_number": "208-542-9114"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 E 1400 N STE 150",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412549",
            "telephone_number": "435-915-4465",
            "fax_number": "435-799-3664"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "STERLING PROVIDER GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2019-11-04",
        "last_updated": "2026-06-17",
        "certification_date": "2026-06-17",
        "status": "A",
        "authorized_official_last_name": "BUNNAGE",
        "authorized_official_first_name": "CORBIN",
        "authorized_official_title_or_position": "PROVIDER/OWER",
        "authorized_official_telephone_number": "208-542-9111",
        "authorized_official_credential": "PA-C"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QX0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Occupational Medicine",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CLIA",
            "identifier": "46D2147193",
            "state": "UT"
        }
    ],
    "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 Jun 17, 2026; 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.