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

NPI Status: Active since February 22, 2007

Contact Information

565 W 465 N STE 130
PROVIDENCE, UT
ZIP 84332
Phone: (435) 752-5553
Fax: (435) 755-5043

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  • Organization
  • Family Medicine
  • Accepts Insurance
  • CLIA Number: 46D1049442
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 01-05-2028

About PEACHTREE FAMILY MEDICINE PC

This page provides the complete NPI Profile along with additional information for Peachtree Family Medicine Pc, a primary care provider established in Providence, Utah operating as a Family Medicine. The healthcare provider is registered in the NPI registry with number 1679608582 assigned on February 2007. The practitioner's primary taxonomy code is 207Q00000X with license number 5916429-1205 (UT). The provider is registered as an organization and their NPI record was last updated 2 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The authorized official of this NPI record is Vera B Carlson Md (Md)

NPI
1679608582
Provider Name
PEACHTREE FAMILY MEDICINE PC
Entity Type
Organization
Location Address
565 W 465 N STE 130 PROVIDENCE, UT 84332
Location Phone
(435) 752-5553
Location Fax
(435) 755-5043
Mailing Address
169 N GATEWAY DR 170 PROVIDENCE, UT 84332
Mailing Phone
(435) 752-5553
Mailing Fax
(435) 755-5043
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
02-22-2007
Last Update Date
11-06-2024
Code Navigator

A primary care provider (PCP) like Peachtree Family Medicine Pc sees people with common medical problems. The primary care provider might be a doctor, physician assistant, nurse practitioner or clinic that are usually involved in your long-term care. A PCP might provide preventive care, treat common medical conditions, identify urgent medical problems and refer you to specialists when necessary. Primary care is usually provided in an outpatient facility but if you are admitted to a hospital your PCP may assist in your care. The most common medical conditions seen by primary care providers are: hypertension, upper respiratory tract infections, depression or anxiety, back pain, arthritis, dermatitis, diabetes, urinary tract infections, 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

Family Medicine

Taxonomy Code
207Q00000X
Type
Allopathic & Osteopathic Physicians
License No.
5916429-1205
License State
UT
Taxonomy Description
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.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area 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
  • Bronze 8000 - EPO
  • 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

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

VERA B CARLSON MD

Authorized Official Title
MD
Authorized Official Phone
(435) 752-5553

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
225939539001MEDICAID (05)UT 

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
46D1049442
Facility Type
Physician Office
Certificate Effective Date
January 06, 2026
Certificate Expiration Date
January 05, 2028
Laboratory Director
VERA B. CARLSON
Certificate Type
Certificate of Waiver
Certificate Type Description
This CLIA certificate is issued to Peachtree Family Medicine Pc 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 1679608582, we treat the final digit (2) 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 68. The final step is to find the difference between that total and the next multiple of ten (70 - 68 = 2).

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.

Pos 1
1
Doubled → 2
Pos 2
6
Unchanged
Pos 3
7
Doubled → 14 → 1 + 4
Pos 4
9
Unchanged
Pos 5
6
Doubled → 12 → 1 + 2
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
5
Unchanged
Pos 9
8
Doubled → 16 → 1 + 6
Check
2
Target digit
Regular digit Doubled digit Check digit

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.

1 → 2 7 → 14 → 5 6 → 12 → 3 8 → 16 → 7 8 → 16 → 7

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 6 + 1 + 4 + 9 + 1 + 2 + 0 + 1 + 6 + 5 + 1 + 6 + 24 = 68

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 68 is 70. The difference is the calculated check digit.

70 - 68 = 2
This NPI is valid
The calculated check digit is 2, which matches the last digit of 1679608582.

Other Providers at the Same Location


The following 2 providers are registered at the same or a nearby location.

Family Medicine
565 W 465 N STE 130
PROVIDENCE, UT 84332
Radiology (Vascular & Interventional Radiology)
565 W 465 N STE 130
PROVIDENCE, UT 84332

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1679608582, enumerated as an "organization" on February 22, 2007.

The provider is located at 565 W 465 N STE 130 PROVIDENCE, UT 84332 and the phone number is (435) 752-5553.

Family Medicine with taxonomy code 207Q00000X.

The provider might be accepting Accepts: BridgeSpan Health Company, Regence BlueCross. Please consult your insurance carrier or call the provider to verify.