LIVING TREE MEDICAL GROUP
NPI 1639754583
Family Medicine in Providence, UT
NPI Status: Active since March 12, 2021
Contact Information
169 N GATEWAY DR STE 170
PROVIDENCE, UT
ZIP 84332
Phone: (435) 565-6043
Fax: (435) 215-4420
- Organization
- Family Medicine
- Accepts Insurance
- CLIA Number: 46D2246257
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 12-21-2025
About LIVING TREE MEDICAL GROUP
This page provides the complete NPI Profile along with additional information for Living Tree Medical Group, a primary care provider established in Providence, Utah operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1639754583 assigned on March 2021. The practitioner's primary taxonomy code is 207Q00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. The authorized official of this NPI record is Kris Coleman (Coc)
- NPI
- 1639754583
- Provider Name
- LIVING TREE MEDICAL GROUP
- Entity Type
- Organization
- Location Address
- 169 N GATEWAY DR STE 170 PROVIDENCE, UT 84332
- Location Phone
- (435) 565-6043
- Location Fax
- (435) 215-4420
- Mailing Address
- 169 N GATEWAY DR STE 170 PROVIDENCE, UT 84332
- Mailing Phone
- (435) 565-6043
- Mailing Fax
- (435) 215-4420
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 03-12-2021
- Last Update Date
- 12-12-2023
- Code Navigator
A primary care provider (PCP) like Living Tree Medical Group sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, etc .
Location Map
Secondary Locations
- 1219 N 400 E
Logan, UT 84341
(435) 565-6043 - 1635 N 200 E
Logan, UT 84341
(435) 565-6043
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine
- Taxonomy Code
- 207Q00000X
- Type
- Allopathic & Osteopathic Physicians
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 261QH0100X | Ambulatory Health Care Facilities | Clinic/Center |
Insurance Plans Accepted
According to publicly available information the provider might be accepting the following health plans from these health insurance companies:
- Bronze 2 Advanced HSA: Aetna network + MinuteClinic + Virtual Primary Care - HMO
- Bronze 4 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Bronze S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 10 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold 3 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Gold S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 5 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver 6 Advanced: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- Silver S: Aetna network + $0 MinuteClinic + $0 CVS Health Virtual Primary Care - HMO
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Gold 1 - HMO
- Gold 1 with Adult Vision Services - HMO
- Gold 8 - HMO
- Silver 1 - HMO
- Silver 1 with Adult Vision Services - HMO
- Silver 12 with First 4 Primary Care Visits Free - HMO
- Silver 8 - HMO
- Connect Bronze Expanded Standard - PPO
- Connect Bronze HDHP - PPO
- Connect Catastrophic - PPO
- Connect Gold - PPO
- Connect Gold Standard - PPO
- Connect Silver - PPO
- Connect Silver Standard - PPO
- High Plains Bronze HDHP - PPO
- High Plains Bronze Standard Expanded - PPO
- High Plains Gold - PPO
- Bronze Essential 8500 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 1500 - EPO
- Regence Standard Silver 5000 - EPO
- Silver 5000 - EPO
- Silver 6200 - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay - EPO
- Healthy Premier Silver Standard - EPO
*Please verify directly with this provider to make sure your insurance plan is currently accepted.
CLIA Information
The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:
- CLIA Number
- 46D2246257
- Facility Type
- Physician Office
- Certificate Effective Date
- December 22, 2023
- Certificate Expiration Date
- December 21, 2025
- Laboratory Director
- MATTHEW J. WELTER
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Living Tree Medical Group to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria.
Reviews for LIVING TREE MEDICAL GROUP
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NPI Validation Check Digit Calculation
The following table explains the step by step NPI number validation process using the ISO standard Luhn algorithm.
| Start with the original NPI number, the last digit is the check digit and is not used in the calculation. | |||||||||
| 1 | 6 | 3 | 9 | 7 | 5 | 4 | 5 | 8 | 3 |
| Step 1: Double the value of the alternate digits, beginning with the rightmost digit. | |||||||||
| 2 | 6 | 6 | 9 | 14 | 5 | 8 | 5 | 16 | |
| Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24. | |||||||||
| 2 + 6 + 6 + 9 + 1 + 4 + 5 + 8 + 5 + 1 + 6 + 24 = 77 | |||||||||
| Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit. | |||||||||
| 80 - 77 = 3 | 3 | ||||||||
The NPI number 1639754583 is valid because the calculated check digit 3 using the Luhn validation algorithm matches the last digit of the original NPI number.
Other Providers at the Same Location
The following provider is registered at the same or nearby location.
| NPI | Name / Type | Taxonomy | Address |
|---|---|---|---|
| 1528419330 | NATALIE JEAN GIBSON DNP Individual | Nurse Practitioner | 169 N GATEWAY DR STE 170 PROVIDENCE, UT 84332 (435) 213-3597 |
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1639754583, enumerated in the NPI registry as an "organization" on March 12, 2021
The provider is located at 169 N Gateway Dr Ste 170 Providence, Ut 84332 and the phone number is (435) 565-6043
This medical organization specializes in Family Medicine with taxonomy code 207Q00000X
The provider might be accepting Accepts: Aetna CVS Health, BridgeSpan Health Company,. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.
The provider's CLIA number is 46D2246257 for a "physician office" facility with a CLIA Certificate of Waiver. This CLIA certificate is issued to perform only waived tests. CLIA defines waived tests as simple tests with a low risk for an incorrect result. Waived tests include certain tests listed in CLIA regulations, tests cleared by the FDA for home use and tests approved by the FDA for waived status and that meet CLIA waiver criteria..
This NPI record was last updated on March 12, 2021. To officially update your NPI information contact the National Plan and Provider Enumeration System (NPPES) at 1-800-465-3203 (NPI Toll-Free) or by email at [email protected].
NPI Profile data is regularly updated with the latest NPI registry information, if you would like to update or remove your NPI Profile in this website please contact us.