NPIMap

Organization Active NPI

Premier Family Medical - City Center

  • Family Medicine Physician
  • Eagle Mountain, UT
National Provider Identifier
1649160235
Registry record updated Jul 7, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
PREMIER FAMILY MEDICAL - CITY CENTER
Practice address
4317 N Pony Express Pkwy
Ste 150
Eagle Mountain, UT 84005-1231
Phone
(801) 788-4779
Fax
(801) 784-6612
NPI assigned
Jul 7, 2025
Last updated
Jul 7, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
PREMIER FAMILY MEDICALAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 7, 2025

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

Authorized official

Name
Heather Guymon
Title
Credentialing Specialist
Phone
(801) 769-2571

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X Primary

Addresses

Primary practice location

4317 N Pony Express Pkwy
Ste 150
Eagle Mountain, UT 84005-1231

Mailing address

275 W 200 N
Lindon, UT 84042-5009
Phone (801) 796-1333

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20130710000079 UT Part B Supplier - Clinic/Group Practice 7416197785 Receives reassigned benefits from 106 practitioners
12 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Lindon, UT; Vineyard, UT; Saratoga Springs, UT; Pleasant Grove, UT; Lehi, UT; Eagle Mountain, UT; American Fork, UT

Other NPIs on the same Medicare enrollment 11

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

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
46D2324266Premier Family Medical4317 N Pony Express Parkway, Suite 150, Eagle Mountain, UT 84005Provider-performed microscopyMay 20, 2027

National Provider Directory

National Provider Directory
Tax ID family
Premier Family Medical LLC6 organizations share this tax ID, including this one
Part of
Premier Family Medical LLC

Other organizations with this tax ID 5

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

Locations

3000 N Triumph Blvd
Ste 220
Lehi, UT 84043
Phone (801) 642-2990

1528 N Commerce Dr
Saratoga Springs, UT 84045
Phone (801) 756-9669

707 E Mill Rd
Ste 303
Vineyard, UT 84059
Phone (801) 224-1300

Practitioners & affiliated clinicians

Practitioners 105

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 105

NPI Registry JSON

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

{
    "created_epoch": "1751846400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1751846400000",
    "number": "1649160235",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "275 W 200 N",
            "city": "LINDON",
            "state": "UT",
            "postal_code": "840425009",
            "telephone_number": "801-796-1333",
            "fax_number": "801-796-0625"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4317 N PONY EXPRESS PKWY",
            "address_2": "STE 150",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840051231",
            "telephone_number": "801-788-4779",
            "fax_number": "801-784-6612"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PREMIER FAMILY MEDICAL - CITY CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "PREMIER FAMILY MEDICAL",
        "enumeration_date": "2025-07-07",
        "last_updated": "2025-07-07",
        "certification_date": "2025-06-19",
        "status": "A",
        "authorized_official_last_name": "GUYMON",
        "authorized_official_first_name": "HEATHER",
        "authorized_official_title_or_position": "CREDENTIALING SPECIALIST",
        "authorized_official_telephone_number": "801-769-2571"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Eagle Mountain, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 7, 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.