GUNDERSEN FAMILY PRACTICE
NPI 1457002503
Nurse Practitioner in Grantsville, UT
NPI Status: Active since January 11, 2022
Contact Information
163 S SR 112 HWY UNIT 106
GRANTSVILLE, UT
ZIP 84029
Phone: (435) 264-4164
Fax: (435) 264-4264
- Organization
- Nurse Practitioner
- Accepts Insurance
- CLIA Number: 46D2257891
- CLIA Cert. Type: Physician Office
- CLIA Exp. Date: 04-11-2028
About GUNDERSEN FAMILY PRACTICE
This page provides the complete NPI Profile along with additional information for Gundersen Family Practice, a provider established in Grantsville, Utah operating as a Nurse Practitioner. The healthcare provider is registered in the NPI registry with number 1457002503 assigned on January 2022. The practitioner's primary taxonomy code is 363L00000X. The provider is registered as an organization and their NPI record was last updated 2 years ago. Gundersen Family Practice operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The provider's is doing business as Gundersen Family Practice. The authorized official of this NPI record is Shaun Gundersen (Owner)
- NPI
- 1457002503
- Provider Legal Name
- SHAUN GUNDERSEN FNP, PLLC
- Other Organization Name
- GUNDERSEN FAMILY PRACTICE
- Other Name Type
- Doing Business As (3)
- Entity Type
- Organization
- Location Address
- 163 S SR 112 HWY UNIT 106 GRANTSVILLE, UT 84029
- Location Phone
- (435) 264-4164
- Location Fax
- (435) 264-4264
- Mailing Address
- 3976 MARSHALL RD GRANTSVILLE, UT 84029
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 01-11-2022
- Last Update Date
- 04-24-2024
- Code Navigator
A nurse practitioner (NP) like Gundersen Family Practice is an experienced registered nurse with a master’s or doctoral degree and advanced clinical training. Nurse practitioners can work in many different specialties including primary care, pediatrics, cardiology, emergency, women’s health, oncology or geriatrics. Nurse practitioners provide services like physical exams, order laboratory tests, manage diseases, write prescriptions, etc.
Location Map
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
Nurse Practitioner
- Taxonomy Code
- 363L00000X
- Type
- Physician Assistants & Advanced Practice Nursing Providers
- Taxonomy Description
- (1) A registered nurse provider with a graduate degree in nursing prepared for advanced practice involving independent and interdependent decision making and direct accountability for clinical judgment across the health care continuum or in a certified specialty. (2) A registered nurse who has completed additional training beyond basic nursing education and who provides primary health care services in accordance with state nurse practice laws or statutes. Tasks performed by nurse practitioners vary with practice requirements mandated by geographic, political, economic, and social factors. Nurse practitioner specialists include, but are not limited to, family nurse practitioners, gerontological nurse practitioners, pediatric nurse practitioners, obstetric-gynecologic nurse practitioners, and school nurse practitioners.
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:
- BridgeSpan Standard Bronze Plan - HMO
- BridgeSpan Standard Gold Plan - HMO
- BridgeSpan Standard Silver Plan - HMO
- Molina Gold Core 1640 - HMO
- Molina Gold Core 1640 Plus with Adult Dental and Vision - HMO
- Molina Gold Standard - HMO
- Molina Silver Core - HMO
- Molina Silver Core Plus with Adult Dental and Vision - HMO
- Molina Silver Core Plus with Adult Vision - HMO
- Molina Silver Saver with Four Free PCP Visits - HMO
- Molina Silver Standard - HMO
- Bronze Essential 9000 Deductible With 4 Copay No Deductible Office Visits - EPO
- Bronze HSA 7000 - EPO
- Gold 2300 - EPO
- Regence Standard Bronze 7500 - EPO
- Regence Standard Gold 2000 - EPO
- Regence Standard Silver 6000 - EPO
- Silver 6500 - EPO
- Healthy Premier Bronze HSA - EPO
- Healthy Premier Expanded Bronze Standard - EPO
- Healthy Premier Gold Copay Office Visits - EPO
- Healthy Premier Gold Standard - EPO
- Healthy Premier Silver Copay Office Visits - 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
- 46D2257891
- Facility Type
- Physician Office
- Certificate Effective Date
- April 12, 2026
- Certificate Expiration Date
- April 11, 2028
- Laboratory Director
- SHAUN T. GUNDERSEN
- Certificate Type
- Certificate of Waiver
- Certificate Type Description
- This CLIA certificate is issued to Gundersen Family Practice 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.
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NPI NPI Number Validation
How NPI Validation Works
The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.
To verify the NPI 1457002503, we treat the final digit (3) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 47. The final step is to find the difference between that total and the next multiple of ten (50 - 47 = 3).
Digit-by-digit view
Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.
Step 1: Double every other digit from the right
Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.
Step 2: Add all digits plus the NPI constant
Add the transformed values, the unchanged digits, and the constant 24.
Step 3: Find the amount needed to reach the next multiple of 10
The next multiple of ten after 47 is 50. The difference is the calculated check digit.
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1457002503, enumerated as an "organization" on January 11, 2022.
The provider is located at 163 S SR 112 HWY UNIT 106 GRANTSVILLE, UT 84029 and the phone number is (435) 264-4164.
Nurse Practitioner with taxonomy code 363L00000X.
The provider might be accepting Accepts: BridgeSpan Health Company, Molina Healthcare,. Please consult your insurance carrier or call the provider to verify.
