MMG Stansbury Family Practice LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

MMG STANSBURY FAMILY PRACTICE LLC

Practice address

576 E Highway 138 Ste 310
Stansbury PK, UT 84074-4028

Phone

(801) 456-2333

Fax

(801) 456-2330

NPI assigned

Dec 29, 2022

Organization subpart

No

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

Authorized official

Name

Cameron Cooper, P.ANPI 1518453976

Title

Owner

Phone

(801) 827-0662

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

• MMG LLC

  dba Mobile Medical Group

  • Nurse Practitioner
  • Meridian, ID
  • NPI 1407469166

  Member Of

  NPD member

Locations

Practitioners 6

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

• Cameron Cooper, PA

  • Physician Assistant
  • Stansbury Park, UT
  • NPI 1518453976
  Medicare reassignment Care Compare group Authorized official
• Lacey A Cooper, NP-C

  • Adult Health Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1639796477
  Medicare reassignment Care Compare group NPD
• Desiree England, FNP-C

  • Family Nurse Practitioner
  • Tooele, UT
  • NPI 1215765490
  Medicare reassignment Care Compare group NPD
• Belle Rowan-Ferris, APRN, FNP-C

  • Family Nurse Practitioner
  • Stansbury Park, UT
  • NPI 1699665406
  Medicare reassignment Care Compare group NPD
• Ashlie Taressa Flynn, DNP, APRN, FNP-C

  • Family Nurse Practitioner
  • Tooele, UT
  • NPI 1972257483
  Medicare reassignment NPD
• Carin Renee James

  • Behavior Technician
  • Tooele, UT
  • NPI 1417565052
  NPD

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

{
    "created_epoch": "1672272000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1740614400000",
    "number": "1730892274",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "576 E HIGHWAY 138 STE 310",
            "city": "STANSBURY PK",
            "state": "UT",
            "postal_code": "840744028",
            "telephone_number": "801-827-0662",
            "fax_number": "801-827-0663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "576 E HIGHWAY 138 STE 310",
            "city": "STANSBURY PK",
            "state": "UT",
            "postal_code": "840744028",
            "telephone_number": "801-456-2333",
            "fax_number": "801-456-2330"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MMG STANSBURY FAMILY PRACTICE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2022-12-29",
        "last_updated": "2025-02-27",
        "certification_date": "2025-02-27",
        "status": "A",
        "authorized_official_last_name": "COOPER",
        "authorized_official_first_name": "CAMERON",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-827-0662",
        "authorized_official_credential": "P.A"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Debra Shinkle, MD
• University of Utah Community Physicians Group (UUHC - Stansbury Health Center)

• Family Medicine Physician in Stansbury PK, UT
• Providers in Stansbury PK, 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 Feb 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.