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MMG STANSBURY FAMILY PRACTICE LLC
NPI 1730892274
Family Medicine in Stansbury Pk, UT

Active since December 29, 2022CLIA 46D2281187 · Waiver
576 E HIGHWAY 138 STE 310, STANSBURY PK, UT 84074(801) 456-2333(801) 456-2330 Get Directions Write a Review

NPPES record last updated: February 27, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Feb 27, 2025, Jan 11, 2023, Jan 3, 2023 and 1 more (4 updates tracked since 2022).

About Mmg Stansbury Family Practice Llc NPPES

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

MMG STANSBURY FAMILY PRACTICE LLC (NPI 1730892274) is a healthcare organization registered as a family medicine in Stansbury Pk, Utah and active in the NPI registry since December 2022. The organization holds a CLIA Waiver certificate valid through May 2, 2027 and lists Cameron Cooper, Owner, as its authorized official.

NPPES Registry Identity

NPI1730892274
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameMMG STANSBURY FAMILY PRACTICE LLC
Location Address576 E HIGHWAY 138 STE 310Stansbury Pk, UT 84074-4028
Mailing Address576 E Highway 138 Ste 310Stansbury Pk, UT 84074-4028 · (801) 827-0662 · Fax (801) 827-0663
Phone(801) 456-2333
Fax(801) 456-2330
Organization SubpartNo
Authorized OfficialCameron CooperOwner · (801) 827-0662
Enumeration DateDecember 29, 2022
Last NPPES UpdateFebruary 27, 20254 updates tracked since enumeration
NPPES CertifiedFebruary 27, 2025
✔ NPI 1730892274 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
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.
576 E HIGHWAY 138 STE 310, Stansbury Pk, UT 84074
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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 Molina Healthcare, University of Utah Health Plans.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)

Mmg Stansbury Family Practice Llc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Mmg Stansbury Family Practice LLC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 3 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Belle Rowan-Ferris, APRN, FNP-C
Nurse Practitioner
NPI 1699665406
576 E HIGHWAY 138 STE 310
Stansbury Park, UT 84074
(801) 827-0662
✔ PECOS✔ Accepts MedicareSame address
Desiree England, FNP-C
Nurse Practitioner
NPI 1215765490
1363 GREEN MEADOWS CT
Tooele, UT 84074
(435) 813-2825
✔ PECOS✔ Accepts Medicare4.9 mi
Ashlie Flynn, DNP, APRN, FNP-C
Nurse Practitioner
NPI 1972257483
2321 N 400 E STE 200
Tooele, UT 84074
(435) 249-0225
8.1 mi
Nicole Greene, APRN
Nurse Practitioner
NPI 1538830989
12921 S VISTA STATION BLVD
Draper, UT 84020
(435) 354-9746
✔ PECOS✔ Accepts Medicare23 mi
Lacey Cooper, NP-C
Nurse Practitioner
NPI 1639796477
50 N MEDICAL DR
Salt Lake City, UT 84132
(702) 281-8904
✔ PECOS✔ Accepts Medicare26 mi

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

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 46D2281187

Mmg Stansbury Family Pratice LLC · Erda, UT
Active · expires May 2, 2027
CLIA Number46D2281187
Laboratory TypePhysician Office
Certificate Effective DateMay 3, 2025
Certificate Expiration DateMay 2, 2027
Laboratory DirectorCameron Cooper
Laboratory Phone(801) 827-0662
Laboratory LocationMmg Stansbury Family Pratice LLC3950 N Tealby Way, Suite 101, Erda, UT 84074
CLIA data matches this NPI record on: Phone
This certificate is issued to a laboratory to perform only waived tests.

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 Mmg Stansbury Family Practice LLC's NPI number?

The NPI number for Mmg Stansbury Family Practice LLC is 1730892274. It was assigned to this organization in the NPPES registry on December 29, 2022.

Where is Mmg Stansbury Family Practice LLC located?

Mmg Stansbury Family Practice LLC is located at 576 E Highway 138 Ste 310, Stansbury Pk, UT 84074. The listed phone number is (801) 456-2333.

What is Mmg Stansbury Family Practice LLC's specialty?

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

Is Mmg Stansbury Family Practice LLC enrolled in Medicare?

Yes. Mmg Stansbury Family Practice LLC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Mmg Stansbury Family Practice LLC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians, all in Nurse Practitioner, reassign their Medicare billing to Mmg Stansbury Family Practice 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 and 3 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Mmg Stansbury Family Practice LLC hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2281187) is associated with this NPI, valid through May 2, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Mmg Stansbury Family Practice LLC accept?

Health plans from Molina Healthcare and University of Utah Health Plans list Mmg Stansbury Family Practice LLC 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 Mmg Stansbury Family Practice LLC was last updated on February 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 20 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.