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CACHE KETAMINE AND MENTAL HEALTH
NPI 1467081448
Physician Assistant in Logan, UT

Active since April 02, 2020CLIA 46D2220642 · Waiver
115 GOLF COURSE RD STE E, LOGAN, UT 84321(435) 999-4059 Get Directions Write a Review

NPPES record last updated: February 23, 2023. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Feb 23, 2023, Apr 2, 2020 (2 updates tracked since 2020).

About Cache Ketamine And Mental Health NPPES

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

CACHE KETAMINE AND MENTAL HEALTH (NPI 1467081448) is a healthcare organization registered as a physician assistant in Logan, Utah and active in the NPI registry since April 2020. The organization holds a CLIA Waiver certificate valid through April 13, 2027 and lists Colby Martin, Owner, as its authorized official.

NPPES Registry Identity

NPI1467081448
Entity TypeOrganization
Primary Taxonomy363A00000X
Legal Business NameMARTIN MEDICAL GROUP LLC
Location Address115 GOLF COURSE RD STE ELogan, UT 84321-5934
Mailing Address115 Golf Course Rd Ste ELogan, UT 84321-5934 · (435) 999-4059
Phone(435) 999-4059
Organization SubpartNo
Authorized OfficialColby MartinOwner · (435) 881-0662
Enumeration DateApril 2, 2020
Last NPPES UpdateFebruary 23, 20232 updates tracked since enumeration
NPPES CertifiedFebruary 23, 2023
✔ NPI 1467081448 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 4

★ Primary SpecialtyPhysician AssistantPhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363A00000X
Definition
A physician assistant is a person who has successfully completed an accredited education program for physician assistant, is licensed by the state and is practicing within the scope of that license. Physician assistants are formally trained to perform many of the routine, time-consuming tasks a physician can do. In some states, they may prescribe medications. They take medical histories, perform physical exams, order lab tests and x-rays, and give inoculations. Most states require that they work under the supervision of a physician.
Also ListedEmergency MedicineTaxonomy 207P00000X
Also ListedFamily MedicineTaxonomy 207Q00000X
Also ListedNurse Practitioner · Psychiatric/Mental HealthTaxonomy 363LP0808X
115 GOLF COURSE RD STE E, Logan, UT 84321
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Other Names 2

Doing Business AsCache Ketamine And Mental Health
Doing Business AsUtah Home Detox

Other Identifiers 1

Other12627418Caqh

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include BridgeSpan Health Company, Regence BlueCross BlueShield of Utah, University of Utah Health Plans.Insurance ›

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 46D2220642

Martin Medical Group LLC · Logan, UT
Active · expires Apr 13, 2027
CLIA Number46D2220642
Laboratory TypePhysician Office
Certificate Effective DateApril 14, 2025
Certificate Expiration DateApril 13, 2027
Laboratory DirectorColby Martin
Laboratory Phone(435) 881-0662
Laboratory LocationMartin Medical Group LLC115 Golf Course Rd, Ste E, Logan, UT 84321
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Other Providers at the Same Location NPPES 15

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

MADISON RAE GROBERG
Physician Assistant (Medical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 999-4059
MELISSA DE LEON MASON
Social Worker (Clinical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 799-5035
KAIMBRE WURSTEN
Social Worker (Clinical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 799-5035
MR. GARRETT RYAN GUNDRY PA-C
Physician Assistant (Medical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 999-4059
STACIE ELISE LATER
Counselor (Mental Health)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 535-3782
KALISITIANE ULUAVE
Social Worker (Clinical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 799-5035
BETHANY ANNE ALLRED CSW
Social Worker (Clinical)
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 799-5035
ALLIE LEEZER CSW
Counselor
115 GOLF COURSE RD STE E
LOGAN, UT 84321
Cache County (435) 799-5035

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Martin Medical Group LLC's NPI number?

The NPI number for Martin Medical Group LLC is 1467081448. It was assigned to this organization in the NPPES registry on April 2, 2020. The provider is doing business as Cache Ketamine And Mental Health and Utah Home Detox.

Where is Martin Medical Group LLC located?

Martin Medical Group LLC is located at 115 Golf Course Rd Ste E, Logan, UT 84321. The listed phone number is (435) 999-4059.

What is Martin Medical Group LLC's specialty?

The primary specialty registered for this NPI is Physician Assistant with taxonomy code 363A00000X.

Does Martin Medical Group LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2220642) is associated with this NPI, valid through April 13, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Martin Medical Group LLC accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Martin Medical Group LLC as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Martin Medical Group LLC was last updated on February 23, 2023. NPI Profile syncs with the weekly NPPES data releases published by CMS.