BRIDGE UTAH MEDICAL GROUP
NPI 1104324904
Physical Medicine & Rehabilitation in Logan, UT

NPI Status: Active since January 26, 2018

Contact Information

1015 E 100 N
LOGAN, UT
ZIP 84321
Phone: (888) 221-0423
Fax: (888) 221-9816

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  • Organization
  • Physical Medicine & Rehabilitation

About BRIDGE UTAH MEDICAL GROUP

Bridge Utah Medical Group is a provider established in Logan, Utah operating as a Physical Medicine & Rehabilitation. The healthcare provider is registered in the NPI registry with number 1104324904 assigned on January 2018. The practitioner's primary taxonomy code is 208100000X. The provider is registered as an organization and their NPI record was last updated 5 years ago. Bridge Utah Medical Group operates as a multi-specialty business group with one or more individual providers who practice different areas of specialization. The authorized official of this NPI record is Cameron G Peterson Md (Chief Medical Officer, Managing Par)

NPI
1104324904
Provider Name
BRIDGE UTAH MEDICAL GROUP
Entity Type
Organization
Location Address
1015 E 100 N LOGAN, UT 84321
Location Phone
(888) 221-0423
Location Fax
(888) 221-9816
Mailing Address
PO BOX 1468 BOUNTIFUL, UT 84011
Mailing Phone
(888) 853-8973
Mailing Fax
(888) 221-9816
Is Sole Proprietor?
N/A
Is Organization Subpart?
No
Enumeration Date
01-26-2018
Last Update Date
03-14-2019
Code Navigator

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

Physical Medicine & Rehabilitation

Taxonomy Code
208100000X
Type
Allopathic & Osteopathic Physicians
Taxonomy Description
Physical medicine and rehabilitation, also referred to as rehabilitation medicine, is the medical specialty concerned with diagnosing, evaluating, and treating patients with physical disabilities. These disabilities may arise from conditions affecting the musculoskeletal system such as neck and back pain, sports injuries, or other painful conditions affecting the limbs, such as carpal tunnel syndrome. Alternatively, the disabilities may result from neurological trauma or disease such as spinal cord injury, head injury or stroke. A physician certified in physical medicine and rehabilitation is often called a physiatrist. The primary goal of the physiatrist is to achieve maximal restoration of physical, psychological, social and vocational function through comprehensive rehabilitation. Pain management is often an important part of the role of the physiatrist. For diagnosis and evaluation, a physiatrist may include the techniques of electromyography to supplement the standard history, physical, x-ray and laboratory examinations. The physiatrist has expertise in the appropriate use of therapeutic exercise, prosthetics (artificial limbs), orthotics and mechanical and electrical devices.

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)
1207Q00000XAllopathic & Osteopathic Physicians

Family Medicine

 

Group Taxonomy 193200000X MULTI-SPECIALTY GROUP

This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

  • Medicare

  • Medicaid


*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

CAMERON G PETERSON MD

Authorized Official Title
CHIEF MEDICAL OFFICER, MANAGING PAR
Authorized Official Phone
(801) 598-8337

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
0000MEDICAID (05)UT 

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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.
1104324904
Step 1: Double the value of the alternate digits, beginning with the rightmost digit.
210462890
Step 2: Add all the doubled and unaffected individual digits from step 1 plus the constant number 24.
2 + 1 + 0 + 4 + 6 + 2 + 8 + 9 + 0 + 24 = 56
Step 3: Subtract the total obtained in step 2 from the next higher number ending in zero, the result is the check digit.
60 - 56 = 44

The NPI number 1104324904 is valid because the calculated check digit 4 using the Luhn validation algorithm matches the last digit of the original NPI number.

Other Providers at the Same Location


The following 2 providers are registered at the same or nearby location.

NPI Name / Type Taxonomy Address
1164912374DR. JARON ANDREW STOUT PHARMD
Individual
Pharmacist (Geriatric)1015 E 100 N
LOGAN, UT 84321
(888) 853-8973
1417465014LEPONT UTAH MEDICAL GROUP
Organization
Physical Medicine & Rehabilitation1015 E 100 N
LOGAN, UT 84321
(435) 770-4673

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1104324904, enumerated in the NPI registry as an "organization" on January 26, 2018

The provider is located at 1015 E 100 N Logan, Ut 84321 and the phone number is (888) 221-0423

This medical organization specializes in Physical Medicine & Rehabilitation with taxonomy code 208100000X

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to make sure your health plan is currently accepted.

This NPI record was last updated on January 26, 2018. 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].
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