Country Corner Family Medicine

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

Legal business name

COUNTRY CORNER FAMILY MEDICINE

Practice address

5460 W Clernates Dr
Salt Lake City, UT 84118-8526

Phone

(435) 749-1488

Fax

(801) 880-2859

NPI assigned

Sep 12, 2018

Last updated

Sep 12, 2018By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Kortney McMullin, NP

Title

Owner

Phone

(435) 749-1488

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1536710400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1536710400000",
    "number": "1801379193",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5460 W CLERNATES DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841188526",
            "telephone_number": "435-749-1488",
            "fax_number": "801-880-2859"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5460 W CLERNATES DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841188526",
            "telephone_number": "435-749-1488",
            "fax_number": "801-880-2859"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COUNTRY CORNER FAMILY MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-09-12",
        "last_updated": "2018-09-12",
        "status": "A",
        "authorized_official_last_name": "MCMULLIN",
        "authorized_official_first_name": "KORTNEY",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "435-749-1488",
        "authorized_official_credential": "NP"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kirstin Coulombe, PT, DPT
• David M. Coulter
• Amanda Counter, CPM, LDEM
• Megan Counter, LCSW
• Elijah D Counterman
• County of Salt Lake (Salt Lake County Corporation)
• County of Salt Lake (Salt Lake Valley Health Department)
• Daniel Ricardo Couriel, M.D.
• Robert J Courtney Jr., PHD
• Jeff M Courtright

• Family Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake 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 Sep 12, 2018; 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.