NORTHEASTERN UTAH MEDICAL GROUP – NPI #1982664199
Family Medicine

Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.

NORTHEASTERN UTAH MEDICAL GROUP is a provider located in ROOSEVELT, UT. NPPES has assigned the NPI number 1982664199 to NORTHEASTERN UTAH MEDICAL GROUP on March 23, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. According to the NPI data, there are 8 additional location(s) assigned to this provider which are listed below. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 207Q00000X from the Health Care Provider Taxonomy code set, which is classified as Family Medicine. Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.

The NPI profile was last updated on Oct 23, 2025. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for NORTHEASTERN UTAH MEDICAL GROUP below.

NPI Profile for
NORTHEASTERN UTAH MEDICAL GROUP

NPI Number
1982664199
Enumeration Date

(more than 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
NORTHEASTERN UTAH MEDICAL GROUP
Primary location
210 W 300 N 7-3
ROOSEVELT, UT 84066
Phone: (435) 722-3971 Fax: (435) 722-6104
8 Other location(s):
15548 W 4000 W
Altamont, UT 84001
Phone: (435) 454-3173
Fax: (435) 454-3990
50 E 200 S
Duchesne, UT 84021
Phone: (435) 738-2426
Fax: (435) 738-2845
96 North 100 West
Manila, UT 84046
Phone: (435) 784-3575
Fax: (435) 784-3505
38080 West SR 35
Tabiona Clinic, UT 84072
Phone: (435) 848-5509
Fax: (435) 848-5507
175 N 200 W 102
Vernal, UT 84078
Phone: (435) 789-4489
379 N 500 W
Vernal, UT 84078-1956
Phone: (435) 781-2030
405 N 500 W
Vernal, UT 84078-1907
Phone: (435) 789-4691
Fax: (435) 722-9291
475 N 500 W
Vernal, UT 84078-1907
Phone: (435) 781-2030
Mailing address
210 W 300 N
ROOSEVELT, UT 84066-2336
Phone: (435) 722-3971 Fax: (435) 722-6104
Organization Subpart
No
Authorized Official
BRENT HALES
CFO
Phone: (435) 722-6164
Updated
Certification Date
Oct 23, 2025

Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.

Identifiers

Identifiers for NORTHEASTERN UTAH MEDICAL GROUP

Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.

DescriptionIssuerStateIdentifier
medicaidUT840276435084
Taxonomy Code(s)

A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.

The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.