Brigham Medical Clinic, Inc.

Primary specialty

Family Medicine PhysicianTaxonomy code 207Q00000X

License

175715-1205 Issued in UT

Legal business name

BRIGHAM MEDICAL CLINIC, INC.

Practice address

600 W Hospital Rd
Brigham City, UT 84302-3006

Phone

(435) 734-2041

Fax

(435) 723-8028

NPI assigned

Aug 31, 2006

Organization subpart

No

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

Authorized official

Name

Mrs. Annette Dickamore

Title

Assistant Office Manager

Phone

(435) 734-2041

Specialties & licenses 6

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 6

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

• Lindee P Allen, FNP

  • Family Nurse Practitioner
  • Brigham City, UT
  • NPI 1194038489
  Medicare reassignment Care Compare group NPD
• Emily Elizabeth George, MSN, FNP-BC

  • Family Nurse Practitioner
  • Brigham City, UT
  • NPI 1992584221
  Medicare reassignment Care Compare group NPD
• Samuel S May

  • Family Nurse Practitioner
  • Ogden, UT
  • NPI 1689369159

  Single Specialty

  Medicare reassignment Care Compare group NPD
• Stephan Michael Moss

  • Family Nurse Practitioner
  • Brigham City, UT
  • NPI 1063906857

  Family Medicine

  Medicare reassignment Care Compare group NPD
• David Gregg Wilding, M.D.

  • Internal Medicine Physician
  • Brigham City, UT
  • NPI 1740391226

  Family Medicine

  Medicare reassignment Care Compare group NPD
• John Robert Markeson, M.D.

  • Internal Medicine Physician
  • Brigham City, UT
  • NPI 1861503419
  NPD

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

{
    "created_epoch": "1156982400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1259107200000",
    "number": "1922119528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 719",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843020719",
            "telephone_number": "435-734-2041",
            "fax_number": "435-723-8028"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "600 W HOSPITAL RD",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843023006",
            "telephone_number": "435-734-2041",
            "fax_number": "435-723-8028"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "BRIGHAM MEDICAL CLINIC, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-08-31",
        "last_updated": "2009-11-25",
        "status": "A",
        "authorized_official_last_name": "DICKAMORE",
        "authorized_official_first_name": "ANNETTE",
        "authorized_official_title_or_position": "ASSISTANT OFFICE MANAGER",
        "authorized_official_telephone_number": "435-734-2041",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "175715-1205",
            "primary": true
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "151481-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "151559-1205",
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "160903-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "163362-1205",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "185588-1205",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Brigham City Orthopedic Clinic PC
• Brigham City Orthopedic LLC
• Brigham City Surgery Center
• Brigham Eye Specialists Inc.
• Brigham Internal Medicine
• Brigham Pediatrics
• Elizabeth Bronson
• Amber Ann Brown
• Brodey Brown
• Jeffery Brent Daniels Brown, D.O.

• Family Medicine Physician in Brigham City, UT
• Providers in Brigham 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 25, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.