Primary Healthcare, PLLC

Primary specialty

Primary Care Clinic/CenterTaxonomy code 261QP2300X

Legal business name

PRIMARY HEALTHCARE, PLLC

Practice address

6095 S Fashion Blvd Ste 220
Murray, UT 84107-7393

Phone

(801) 758-8735

Fax

(801) 769-3991

NPI assigned

Oct 26, 2022

Organization subpart

No

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

Authorized official

Name

Kevin Mangum, DONPI 1609140847

Title

Ceo/Physician

Phone

(801) 758-8735

Specialties & licenses 7

Addresses

Medicare fee-for-service enrollment

Enrolled in UT2 enrollments

Enrollment records 2

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

Practitioners 4

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

• Kevin Mangum, D.O.

  • Sports Medicine (Family Medicine) Physician
  • Murray, UT
  • NPI 1609140847
  Medicare reassignment Care Compare group NPD Authorized official
• Whitney Corinne John, APRN

  • Family Nurse Practitioner
  • Murray, UT
  • NPI 1780308833
  Medicare reassignment Care Compare group NPD
• Tiffany Rose Pulgiano, DNP, A/GNP-C

  • Primary Care Nurse Practitioner
  • West Jordan, UT
  • NPI 1538542840
  Medicare reassignment Care Compare group NPD
• Rosilee W Barker, PA C

  • Physician Assistant
  • Murray, UT
  • NPI 1326017674
  NPD (past)

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

{
    "created_epoch": "1666742400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1685664000000",
    "number": "1700503182",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6095 S FASHION BLVD STE 220",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077393",
            "telephone_number": "801-758-8735",
            "fax_number": "801-769-3991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6095 S FASHION BLVD STE 220",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841077393",
            "telephone_number": "801-758-8735",
            "fax_number": "801-769-3991"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PRIMARY HEALTHCARE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-10-26",
        "last_updated": "2023-06-02",
        "certification_date": "2023-06-02",
        "status": "A",
        "authorized_official_last_name": "MANGUM",
        "authorized_official_first_name": "KEVIN",
        "authorized_official_title_or_position": "CEO/PHYSICIAN",
        "authorized_official_telephone_number": "801-758-8735",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "207QS0010X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207XX0005X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Orthopaedic Surgery, Sports Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QM2500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Medical Specialty",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Primary Care",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• James Robert Price, M.D.
• Madison Price
• Raymond Richard Price, M.D.
• Robert Sheldon Price, M.D.
• Sandra Priedeman, LCSW
• Shaon Primus
• Jessica Sydney Principe, MS, OTR/L
• Private Healthcare Facilities
• Proactive Physical Trerapy LLC
• Kelsey Marie Probst, PA-C

• Primary Care Clinic/Center in Murray, UT
• Providers in Murray, UT by specialty
• Primary Care Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2023; 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.