HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH
NPI 1508518085
Clinic/Center - Multi-Specialty in Holladay, UT

Q: What is Health Diversified - Medical Group Of Utah's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Active since January 25, 2022

4544 S HOLLADAY BLVD, HOLLADAY, UT 84117(801) 682-6817(385) 213-0356 Get Directions Write a Review

NPPES record last updated: March 6, 2026. Verified against the NPPES registry weekly; last sync: November 01, 2026.

Record update history: Mar 6, 2026, Feb 1, 2022, Jan 25, 2022 (3 updates tracked since 2022).

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About Health Diversified - Medical Group Of Utah NPPES

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

HEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH (NPI 1508518085) is a healthcare organization registered as a multi-specialty in Holladay, Utah and active in the NPI registry since January 2022. The organization lists Ann Smith, Authorized Official, as its authorized official.

NPPES Registry Identity

NPI1508518085

Entity TypeOrganization

Primary Taxonomy261QM1300X

Legal Business NameHEALTH DIVERSIFIED - MEDICAL GROUP OF UTAH

Location Address4544 S HOLLADAY BLVDHolladay, UT 84117-4404

Mailing Address5986 S Tolcate Woods LnHolladay, UT 84121-1536 · (801) 682-6817 · Fax (385) 213-0356

Phone(801) 682-6817

Fax(385) 213-0356

Organization SubpartNo

Authorized OfficialAnn SmithAuthorized Official · (801) 682-6817

Enumeration DateJanuary 25, 2022

Last NPPES UpdateMarch 6, 20263 updates tracked since enumeration

NPPES CertifiedMarch 6, 2026

✔ NPI 1508518085 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 15

★ Primary SpecialtyClinic/Center · Multi-SpecialtyAmbulatory Health Care Facilities

Taxonomy Code261QM1300X

Also ListedPsychologist · CounselingTaxonomy 103TC1900X

Also ListedSocial Worker · ClinicalTaxonomy 1041C0700X

Also ListedDietitian, RegisteredTaxonomy 133V00000X

Also ListedEmergency MedicineTaxonomy 207P00000X

Also ListedFamily MedicineTaxonomy 207Q00000X

Also ListedInternal MedicineTaxonomy 207R00000X

Also ListedMedical Genetics · Clinical Genetics (M.D.)Taxonomy 207SG0201X

Also ListedObstetrics & GynecologyTaxonomy 207V00000X

Also ListedPediatricsTaxonomy 208000000X

Also ListedPhysical TherapistTaxonomy 225100000X

Also ListedCase ManagementTaxonomy 251B00000X

Also ListedClinic/Center · Corporate HealthTaxonomy 261QC1800X

Also ListedPhysician AssistantTaxonomy 363A00000X

Also ListedNurse PractitionerTaxonomy 363L00000X

4544 S HOLLADAY BLVD, Holladay, UT 84117

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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 Molina Healthcare.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Health Diversified - Medical Group Of Utah is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Health Diversified - Medical Group Of Utah, which bills Medicare for the services this clinician delivers.

Clinician (1)

Douglas Smith, M.D.

Family Practice

NPI 1174681928

4544 S HOLLADAY BLVD
Holladay, UT 84117

(801) 682-6817

✔ PECOS✔ Accepts MedicareSame address

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Health Diversified - Medical Group Of Utah's NPI number?

The NPI number for Health Diversified - Medical Group Of Utah is 1508518085. It was assigned to this organization in the NPPES registry on January 25, 2022.

Where is Health Diversified - Medical Group Of Utah located?

Health Diversified - Medical Group Of Utah is located at 4544 S Holladay Blvd, Holladay, UT 84117. The listed phone number is (801) 682-6817.

What is Health Diversified - Medical Group Of Utah's specialty?

The primary specialty registered for this NPI is Clinic/Center, specializing in Multi-Specialty, with taxonomy code 261QM1300X.

Is Health Diversified - Medical Group Of Utah enrolled in Medicare?

Yes. Health Diversified - Medical Group Of Utah is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Health Diversified - Medical Group Of Utah?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Health Diversified - Medical Group Of Utah. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Health Diversified - Medical Group Of Utah accept?

Health plans from Molina Healthcare list Health Diversified - Medical Group Of Utah 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 Health Diversified - Medical Group Of Utah was last updated on March 6, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 8 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.