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INGEGRATIVE MEDICAL ASSICATES
NPI 1023344272
Family Medicine in Provo, UT

Active since October 22, 2009CLIA 46D1104021 · Waiver
3650 N UNIVERSITY AVE, SUITE 200, PROVO, UT 84604(801) 375-7100(801) 375-7102 Get Directions Write a Review

NPPES record last updated: October 22, 2009. Verified against the NPPES registry weekly; last sync: July 19, 2026.

About Ingegrative Medical Assicates NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

INGEGRATIVE MEDICAL ASSICATES (NPI 1023344272) is a healthcare organization registered as a family medicine in Provo, Utah and active in the NPI registry since October 2009. The organization holds a CLIA Waiver certificate valid through August 23, 2027 and lists Stuart Porter, Physician, as its authorized official.

NPPES Registry Identity

NPI1023344272
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameSPORTERDO LLC
Location Address3650 N UNIVERSITY AVE, SUITE 200Provo, UT 84604-6656
Mailing Address3650 N University Ave, Suite 200Provo, UT 84604-6656 · (801) 375-7100 · Fax (801) 375-7102
Phone(801) 375-7100
Fax(801) 375-7102
Organization SubpartNo
Authorized OfficialStuart PorterPhysician · (801) 375-7100
Enumeration DateOctober 22, 2009
✔ NPI 1023344272 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 288579 1204
Definition

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.

3650 N UNIVERSITY AVE, Provo, UT 84604
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Other Names 1

Doing Business AsIngegrative Medical Assicates

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

CLIA Laboratory Certificates CMS CLIA

Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.

Certificate of Waiver 46D1104021

Integrative Medical Associates · Provo, UT
Active · expires Aug 23, 2027
CLIA Number46D1104021
Laboratory TypePhysician Office
Certificate Effective DateAugust 24, 2025
Certificate Expiration DateAugust 23, 2027
Laboratory DirectorVaughn T. Johnson
Laboratory Phone(801) 420-0947
Laboratory LocationIntegrative Medical Associates3650 N University Ave Ste 200, Provo, UT 84604
CLIA data matches this NPI record on: Address
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 5

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

STUART B PORTER D.O.
Family Medicine
3650 N UNIVERSITY AVE, SUITE 200
PROVO, UT 84604
Utah County (801) 375-7100
CHARLES HERBERT STEWART M.D.
Plastic Surgery
3650 N UNIVERSITY AVE, SUITE 200
PROVO, UT 84604
Utah County (801) 375-4100
TYLER HOBBS FNP
Nurse Practitioner (Primary Care)
3650 N UNIVERSITY AVE
PROVO, UT 84604
Utah County (801) 818-1940
MS. REBEKAH MICHELLE HOSMAN PA-C
Physician Assistant (Medical)
3650 N UNIVERSITY AVE, #200
PROVO, UT 84604
Utah County (801) 375-7100
INTEGRATIVE MEDICAL ASSOCIATES
Family Medicine
3650 N UNIVERSITY AVE, SUITE 200
PROVO, UT 84604
Utah County (801) 375-7100

Frequently Asked Questions

What is SPORTERDO LLC's NPI number?

The NPI number assigned to this healthcare provider is 1023344272, enumerated as an "organization" on October 22, 2009.

Where is the provider located?

The provider is located at 3650 N UNIVERSITY AVE SUITE 200 PROVO, UT 84604 and the phone number is (801) 375-7100.

What is the provider's specialty?

Family Medicine with taxonomy code 207Q00000X.