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PEACHTREE FAMILY MEDICINE PC
NPI 1679608582
Family Medicine in Providence, UT

Active since February 22, 2007CLIA 46D1049442 · Waiver
565 W 465 N STE 130, PROVIDENCE, UT 84332(435) 752-5553(435) 755-5043 Get Directions Write a Review

NPPES record last updated: November 6, 2024. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Nov 6, 2024, Jul 27, 2017 (2 updates tracked since 2017).

About Peachtree Family Medicine Pc NPPES

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

PEACHTREE FAMILY MEDICINE PC (NPI 1679608582) is a healthcare organization registered as a family medicine in Providence, Utah and active in the NPI registry since February 2007. The organization holds a CLIA Waiver certificate valid through January 5, 2028 and lists Vera B Carlson, Md, as its authorized official.

NPPES Registry Identity

NPI1679608582
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NamePEACHTREE FAMILY MEDICINE PC
Location Address565 W 465 N STE 130Providence, UT 84332-4802
Mailing Address169 N Gateway Dr, 170Providence, UT 84332-9855 · (435) 752-5553 · Fax (435) 755-5043
Phone(435) 752-5553
Fax(435) 755-5043
Organization SubpartNo
Authorized OfficialVera B CarlsonMd · (435) 752-5553
Enumeration DateFebruary 22, 2007
Last NPPES UpdateNovember 6, 20242 updates tracked since enumeration
NPPES CertifiedNovember 6, 2024
✔ NPI 1679608582 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
License✔ Licensed in UT · 5916429-1205
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
565 W 465 N STE 130, Providence, UT 84332
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Other Identifiers 1

Medicaid225939539001UT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE 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 46D1049442

Peachtree Family Medicine · Providence, UT
Active · expires Jan 5, 2028
CLIA Number46D1049442
Laboratory TypePhysician Office
Certificate Effective DateJanuary 6, 2026
Certificate Expiration DateJanuary 5, 2028
Laboratory DirectorVera B. Carlson
Laboratory Phone(435) 512-6903
Laboratory LocationPeachtree Family Medicine565 W 465 N, #130, Providence, UT 84332
CLIA data matches this NPI record on: Name
This certificate is issued to a laboratory to perform only waived tests.

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.

VERA B CARLSON MD, PHD
Family Medicine
565 W 465 N STE 130
PROVIDENCE, UT 84332
Cache County (435) 752-5553
CACHE VALLEY VEIN
Radiology (Vascular & Interventional Radiology)
565 W 465 N STE 130
PROVIDENCE, UT 84332
Cache County (435) 753-2842

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 Peachtree Family Medicine PC's NPI number?

The NPI number for Peachtree Family Medicine PC is 1679608582. It was assigned to this organization in the NPPES registry on February 22, 2007.

Where is Peachtree Family Medicine PC located?

Peachtree Family Medicine PC is located at 565 W 465 N Ste 130, Providence, UT 84332. The listed phone number is (435) 752-5553.

What is Peachtree Family Medicine PC's specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Does Peachtree Family Medicine PC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D1049442) is associated with this NPI, valid through January 5, 2028. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Peachtree Family Medicine PC accept?

Health plans from BridgeSpan Health Company, Regence BlueCross BlueShield of Utah and University of Utah Health Plans list Peachtree Family Medicine PC 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 Peachtree Family Medicine PC was last updated on November 6, 2024. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.