Active NPI
Carlin D. Utterback, M.D.
- Family Medicine Physician
- Brookings, OR
National Provider Identifier
1720001142
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Family Medicine Physician
- License
- MD126309
- Practice address
- 500 5TH St
Brookings, OR 97415-9702 - Phone
- (541) 412-2000
- Fax
- (541) 412-2081
- NPI assigned
- Jul 26, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician | 207Q00000X | MD126309 | OR | Primary |
Addresses
Primary practice location
500 5TH St
Brookings, OR 97415-9702
Mailing address
94220 4TH St
Gold Beach, OR 97444-7756
Phone (541) 247-3000
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 500611363 | Medicaid | OR | |
| 93-0937095 | Other | OR | CURRY HEALTH DISTRICT TAX ID |
| 0000ZGBDG | Other | OR | CURRY GEN. HOSP./BROOKINGS MED. CTR PART B |
| 381322 | Other | OR | CURRY GENERAL HOSPITAL PART A |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| MD126309 | OR | MD | Family Medicine Physician |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Sage Family Medicine Associates, PA | Past | Accepting new patients | |
| Garner Field Family Medicine PA | Family Medicine | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Rural Health Clinic/Center
- Uvalde, TX
- NPI 1114173416
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1153872000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678147200000",
"number": "1720001142",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "94220 4TH ST",
"city": "GOLD BEACH",
"state": "OR",
"postal_code": "974447756",
"telephone_number": "541-247-3000",
"fax_number": "541-247-3101"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "500 5TH ST",
"city": "BROOKINGS",
"state": "OR",
"postal_code": "974159702",
"telephone_number": "541-412-2000",
"fax_number": "541-412-2081"
}
],
"practiceLocations": [],
"basic": {
"last_name": "UTTERBACK",
"first_name": "CARLIN",
"middle_name": "D.",
"credential": "M.D.",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-26",
"last_updated": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "207Q00000X",
"taxonomy_group": "",
"desc": "Family Medicine",
"state": "OR",
"license": "MD126309",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "500611363",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CURRY HEALTH DISTRICT TAX ID",
"identifier": "93-0937095",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CURRY GEN. HOSP./BROOKINGS MED. CTR PART B",
"identifier": "0000ZGBDG",
"state": "OR"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CURRY GENERAL HOSPITAL PART A",
"identifier": "381322",
"state": "OR"
}
],
"endpoints": [],
"other_names": []
}Other providers in Brookings, OR
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.