Premier Family Medical - American Fork
Organization Active NPI Family Medicine Physician · American Fork, UT
NPI 1922442904 · NPPES record last updated Mar 22, 2024
Key facts
- NPI
- 1922442904
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- Legal business name
- PREMIER FAMILY MEDICAL - AMERICAN FORK
- Practice address
- 226 N 1100 E
American Fork, UT 84003-2054 - Phone
- (801) 855-3841
- Fax
- (801) 855-3854
- NPI assigned
- Apr 22, 2013
- Organization subpart
- Yes
- Parent organization (as reported)
- PREMIER FAMILY MEDICAL LLC
Authorized official
- Name
- Heather Guymon
- Title
- Credentialing Specialist
- Phone
- (801) 769-2571
Other NPIs on the same Medicare enrollment 11
Practitioners 7
-
Holden L. Brown, MD
-
Chad Michael Duford, PA-C
-
Daniel Glade, MD
-
Garrett B Smith, DO
-
Kent Willis, D.O.
Laboratory certificates & supplier records
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D0522449 | Premier Family Medical | Provider-performed microscopy | Oct 31, 2027 |
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20130710000079 | UT | Part B Supplier - Clinic/Group Practice | 7416197785 |
Receives reassigned benefits from 106 practitioners 12 other NPIs on this enrollment This NPI is an additional NPI on the enrollment Practice locations: Lindon, UT; Vineyard, UT; Saratoga Springs, UT; Pleasant Grove, UT; Lehi, UT; Eagle Mountain, UT; American Fork, UT |
National Provider Directory
- Part of
- Premier Family Medical - Traverse Mountain
Locations
275 W 200 N
Lindon, UT 84042
Phone (801) 796-1333
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | Yes |
Addresses
Primary practice location
226 N 1100 E
American Fork, UT 84003-2054
Mailing address
275 W 200 N
Lindon, UT 84042-5009
Phone (801) 796-1333
Other providers in American Fork, UT
- Lindsey Nicole Porter
- Sandra Lee Porter
- Pamela Poulsen
- Julie Lynn Powers
- Preemptive Health LLC
- Premier Family Medical - American Fork Physical Therapy
- Premier Family Medical - Dermatology
- Christin Buck Prestwich
- Mackenzie Rae Preza
- Graham Brent Prime
All providers in American Fork, UT · Family Medicine Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Mar 22, 2024. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.