Living Tree Medical Group

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

LIVING TREE MEDICAL GROUP

Practice address

1635 N 200 E
Logan, UT 84341-1913

Phone

(435) 565-6043

Fax

(435) 215-4420

NPI assigned

Mar 12, 2021

Organization subpart

No

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

Authorized official

Name

Kris Coleman

Title

Coc

Phone

(435) 770-2131

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

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

CLIA laboratory certificates

Locations

Subparts reporting this organization as parent 1

Organizations that report themselves as subparts in NPPES and name this organization, in the same state, as their parent.

• Living Tree Urgent Care

  • Urgent Care Clinic/Center
  • Logan, UT
  • NPI 1366112922
  NPPES parent name

Practitioners 12

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Savannah Alder, FNP

  • Family Nurse Practitioner
  • Logan, UT
  • NPI 1811519085

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Kevin R Duke, D.O.

  • Family Medicine Physician
  • Providence, UT
  • NPI 1003882713
  Medicare reassignment Care Compare group NPD
• Jennifer Carter Mosteller, NP

  • Nurse Practitioner
  • Logan, UT
  • NPI 1801356530

  Family Medicine

  Medicare reassignment Care Compare group NPD
• Drew Robert Thurman

  • Nurse Practitioner
  • Nibley, UT
  • NPI 1811788821
  Medicare reassignment Care Compare group NPD
• Matthew John Welter, M.D.

  • Family Medicine Physician
  • Logan, UT
  • NPI 1164486064
  Medicare reassignment Care Compare group NPD
• John David Malouf, D.O.

  • Family Medicine Physician
  • Logan, UT
  • NPI 1992097612
  Medicare reassignment NPD
• Justen Watkins, DO

  • General Practice Physician
  • Logan, UT
  • NPI 1689090060
  Medicare reassignment NPD
• Gordon Stacey Wood, M.D.

  • Plastic Surgery within the Head & Neck (Otolaryngology) Physician
  • Logan, UT
  • NPI 1255328969
  Medicare reassignment NPD
• Gina Gasser Jordan, FNP

  • Nurse Practitioner
  • North Logan, UT
  • NPI 1346104973
  Medicare reassignment
• Candice Elizabeth Macari, PA-C

  • Physician Assistant
  • Providence, UT
  • NPI 1649621228
  NPD
• William Betz

  • Emergency Medicine Physician
  • Gilbert, AZ
  • NPI 1679861157
  NPD
• Jess Henry Jewett, M.D.

  • Personal Emergency Response Attendant
  • Providence, UT
  • NPI 1457514812
  NPD (past)

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

{
    "created_epoch": "1615507200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1752192000000",
    "number": "1639754583",
    "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",
            "fax_number": "435-220-2030"
        },
        {
            "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": "435-215-4420"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "169 N Gateway Dr Ste 170",
            "address_purpose": "LOCATION",
            "city": "Providence",
            "state": "UT",
            "postal_code": "843329855",
            "country_code": "US",
            "telephone_number": "435-565-6043",
            "fax_number": "435-215-4420",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "1219 N 400 E",
            "address_purpose": "LOCATION",
            "city": "Logan",
            "state": "UT",
            "postal_code": "843412321",
            "country_code": "US",
            "telephone_number": "435-565-6043",
            "fax_number": "435-215-4420",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LIVING TREE MEDICAL GROUP",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-03-12",
        "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": "COC",
        "authorized_official_telephone_number": "435-770-2131"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QH0100X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Health Service",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lifestyle Medical Distributors LLC (HSA Depot)
• Mark Emmett Lindhardt, PHARMD
• Noah James Linford
• Sarah Liston, DO
• Lila Jaclyn Littledike, SLP
• Living Tree Urgent Care
• Dillon James Lloyd
• Logan City Corporation (Logan City Fire Department)
• Logan City School District
• Logan Dental Assoicates

• Family Medicine Physician in Logan, UT
• Providers in Logan, UT by specialty
• Family Medicine Physician in Utah

• 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.