NPIMap

Organization Active NPI

Sundara MHS LLC

  • Multi-Specialty Clinic/Center
  • Bluffdale, UT
National Provider Identifier
1730924580
Registry record updated May 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
SUNDARA MHS LLC
Doing business as
Sundara Medical
Practice address
14629 S Porter Rockwell Blvd
Bluffdale, UT 84065
Phone
(801) 410-1100
Fax
(801) 332-9577
NPI assigned
Jun 25, 2024
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 28, 2025

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

Authorized official

Name
Tamara Broadhead, DNPNPI 1124548789
Title
Medical Director
Phone
(817) 319-9475

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary
Psychiatric/Mental Health Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LP0808X

Addresses

Primary practice location

14629 S Porter Rockwell Blvd
Bluffdale, UT 84065

Mailing address

7533 S Center View CT Ste N
West Jordan, UT 84084-5526

Other names 1

  • Sundara Medical Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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

NPI Registry JSON

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

{
    "created_epoch": "1719273600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1748390400000",
    "number": "1730924580",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7533 S CENTER VIEW CT STE N",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840845526"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "14629 S PORTER ROCKWELL BLVD",
            "city": "BLUFFDALE",
            "state": "UT",
            "postal_code": "84065",
            "telephone_number": "801-410-1100",
            "fax_number": "801-332-9577"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SUNDARA MHS LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-25",
        "last_updated": "2025-05-28",
        "certification_date": "2025-05-28",
        "status": "A",
        "authorized_official_last_name": "BROADHEAD",
        "authorized_official_first_name": "TAMARA",
        "authorized_official_title_or_position": "MEDICAL DIRECTOR",
        "authorized_official_telephone_number": "817-319-9475",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363LP0808X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Sundara Medical",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Bluffdale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 28, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.