UTAH MODERN MEDICAL LLC
NPI 1689310948
General Practice in Lehi, UT
About Utah Modern Medical Llc NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
UTAH MODERN MEDICAL LLC (NPI 1689310948) is a healthcare organization registered as a general practice in Lehi, Utah and active in the NPI registry since May 2022. The organization lists Dave Bullock, Owner, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 3
Group Practice 1
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
Utah Modern Medical Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
2Medicare enrollment records show 2 clinicians reassign Medicare billing to Utah Modern Medical LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.
Clinicians, nearest first (2)
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 Utah Modern Medical LLC's NPI number?
The NPI number for Utah Modern Medical LLC is 1689310948. It was assigned to this organization in the NPPES registry on May 10, 2022.
Where is Utah Modern Medical LLC located?
Utah Modern Medical LLC is located at 3300 N Ashton Blvd Ste 450, Lehi, UT 84048. The listed phone number is (385) 455-7170.
What is Utah Modern Medical LLC's specialty?
The primary specialty registered for this NPI is General Practice with taxonomy code 208D00000X.
Is Utah Modern Medical LLC enrolled in Medicare?
Yes. Utah Modern Medical LLC is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Utah Modern Medical LLC?
According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Family Practice, reassign their Medicare billing to Utah Modern Medical LLC. 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
When was this NPI record last updated?
The NPPES record for Utah Modern Medical LLC was last updated on September 17, 2026. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 33 days 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.
# Utah Modern Medical Llc · NPI 1689310948
General Practice organization in Lehi, Utah. Organization record, active in the CMS NPPES registry since May 10, 2022.
## Identity
- **NPI:** 1689310948 (Entity type: Organization)
- **Enumerated:** May 10, 2022
- **Primary specialty:** General Practice · taxonomy 208D00000X
- **Organization subpart:** No
- **Authorized official:** Dave Bullock, OWNER
## Practice location
- **Address:** 3300 N ASHTON BLVD STE 450, Lehi, UT 84048-5340
- **Phone:** (385) 455-7170 · **Fax:** (888) 823-5887
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 2 clinicians (Family Practice) reassign Medicare billing to this organization (form CMS-855R); 1 practice at this address · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** September 17, 2026
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Source: [NPI Profile](https://npiprofile.com/npi/1689310948) · Data from the CMS NPPES public registry.