Country Doc Shop LLC

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COUNTRY DOC SHOP LLC

Practice address

555 S Sunset Dr
Cedar City, UT 84720-3538

Phone

(435) 233-6350

NPI assigned

Mar 13, 2025

Organization subpart

No

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

Authorized official

Name

David A Dalton, DONPI 1659755320

Title

Owner Provider

Phone

(435) 233-6350

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT, NV2 enrollments

Enrollment records 2

Locations

Practitioners 3

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

• David A Dalton, DO

  • Family Medicine Physician
  • Cedar City, UT
  • NPI 1659755320

  Multi-Specialty, NV

  Medicare reassignment NPD Authorized official
• Rebecca C Whittaker, D.C.

  • Pediatric Chiropractor
  • Cedar City, UT
  • NPI 1922334176
  NPD
• Tyler Whittaker, D.C.

  • Chiropractor
  • Cedar City, UT
  • NPI 1831216811
  NPD

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

{
    "created_epoch": "1741824000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762732800000",
    "number": "1750181376",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2374 W NATURE VIEW DR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847201862",
            "telephone_number": "435-233-6350",
            "fax_number": "860-718-3751"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S SUNSET DR",
            "city": "CEDAR CITY",
            "state": "UT",
            "postal_code": "847203538",
            "telephone_number": "435-233-6350"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "40 Main St",
            "address_purpose": "LOCATION",
            "city": "Caliente",
            "state": "NV",
            "postal_code": "89008",
            "country_code": "US",
            "telephone_number": "435-233-6350",
            "fax_number": "860-718-3751",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "COUNTRY DOC SHOP LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-03-13",
        "last_updated": "2025-11-10",
        "certification_date": "2025-11-10",
        "status": "A",
        "authorized_official_last_name": "DALTON",
        "authorized_official_first_name": "DAVID",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "OWNER PROVIDER",
        "authorized_official_telephone_number": "435-233-6350",
        "authorized_official_credential": "DO"
    },
    "taxonomies": [
        {
            "code": "204D00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Neuromusculoskeletal Medicine & OMM",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Cornerstone Caregiving West LLC
• Douglas Willis Corry, DMD
• Jacob Corry, DO
• Mark Willis Corry, MD
• Robert D Corry, MD
• David Thomas Cowley, N.P.-C
• Jamie Cox, APRN
• Nancy Diane Cox
• Stephanie Crank
• Cassidy Crawford

• Family Medicine Physician in Cedar City, UT
• Providers in Cedar City, 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 Nov 10, 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.