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BLUE SAGE MEDICAL LLC
NPI 1487016226
Nurse Practitioner - Primary Care in Park City, UT

Active since March 22, 2016
6300 SAGEWOOD DR, SUITE H-532, PARK CITY, UT 84098(801) 718-7280(888) 853-5162 Get Directions Write a Review

NPPES record last updated: August 29, 2017. Verified against the NPPES registry weekly; last sync: July 26, 2026.

Record update history: Aug 29, 2017, Mar 22, 2016 (2 updates tracked since 2016).

About Blue Sage Medical Llc NPPES

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

BLUE SAGE MEDICAL LLC (NPI 1487016226) is a healthcare organization registered as a primary care in Park City, Utah and active in the NPI registry since March 2016. The organization lists Gina Coccimiglio, Agpcnp, as its authorized official.

NPPES Registry Identity

NPI1487016226
Entity TypeOrganization
Primary Taxonomy363LP2300X
Legal Business NameBLUE SAGE MEDICAL LLC
Location Address6300 SAGEWOOD DR, SUITE H-532Park City, UT 84098-7502
Mailing Address6300 Sagewood Dr, Suite H-532Park City, UT 84098-7502 · (801) 718-7280 · Fax (888) 853-5162
Phone(801) 718-7280
Fax(888) 853-5162
Organization SubpartNo
Authorized OfficialGina CoccimiglioAgpcnp · (801) 718-7280
Enumeration DateMarch 22, 2016
Last NPPES UpdateAugust 29, 20172 updates tracked since enumeration
✔ NPI 1487016226 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyNurse Practitioner · Primary CarePhysician Assistants & Advanced Practice Nursing Providers
Taxonomy Code363LP2300X
License✔ Licensed in UT · 123071-4405
6300 SAGEWOOD DR, Park City, UT 84098
Open in Google Maps ↗

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

Other Providers at the Same Location NPPES 2

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

MS. EDNA ANN COOPER COTA/L
Occupational Therapy Assistant
6300 SAGEWOOD DR, SUITE H423
PARK CITY, UT 84098
Summit County (888) 499-4904
DR. ARIEL FORD PSYD
Psychologist
6300 SAGEWOOD DR, #434
PARK CITY, UT 84098
Summit County (435) 640-7903

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 Blue Sage Medical LLC's NPI number?

The NPI number for Blue Sage Medical LLC is 1487016226. It was assigned to this organization in the NPPES registry on March 22, 2016.

Where is Blue Sage Medical LLC located?

Blue Sage Medical LLC is located at 6300 Sagewood Dr Suite H-532, Park City, UT 84098. The listed phone number is (801) 718-7280.

What is Blue Sage Medical LLC's specialty?

The primary specialty registered for this NPI is Nurse Practitioner, specializing in Primary Care, with taxonomy code 363LP2300X.

When was this NPI record last updated?

The NPPES record for Blue Sage Medical LLC was last updated on August 29, 2017. NPI Profile syncs with the weekly NPPES data releases published by CMS.