1. Home
  2. Directory
  3. Utah
  4. Roosevelt
  5. Family Medicine
  6. NPI Profile

NORTHEASTERN UTAH MEDICAL GROUP
NPI 1982664199
Family Medicine in Roosevelt, UT

Active since March 23, 2006
210 W 300 N 7-3, ROOSEVELT, UT 84066(435) 722-3971(435) 722-6104 Get Directions Write a Review

NPPES record last updated: October 23, 2025. Verified against the NPPES registry weekly; last sync: October 18, 2026.

Record update history: May 14, 2019, Apr 17, 2017 (2 updates tracked since 2017).

About Northeastern Utah Medical Group NPPES

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

NORTHEASTERN UTAH MEDICAL GROUP (NPI 1982664199) is a healthcare organization registered as a family medicine in Roosevelt, Utah and active in the NPI registry since March 2006. The organization maintains 8 additional practice locations and lists Brent H Hales, Cfo, as its authorized official.

NPPES Registry Identity

NPI1982664199
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameNORTHEASTERN UTAH MEDICAL GROUP
Location Address210 W 300 N 7-3Roosevelt, UT 84066
Mailing Address210 W 300 NRoosevelt, UT 84066-2336 · (435) 722-3971 · Fax (435) 722-6104
Phone(435) 722-3971
Fax(435) 722-6104
Organization SubpartNo
Authorized OfficialBrent H HalesCfo · (435) 722-6164
Enumeration DateMarch 23, 2006
Last NPPES UpdateOctober 23, 20252 updates tracked since enumeration
NPPES CertifiedOctober 23, 2025
✔ NPI 1982664199 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 11

★ 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.
Also ListedDermatologyTaxonomy 207N00000X
Also ListedInternal MedicineTaxonomy 207R00000X
Also ListedObstetrics & GynecologyTaxonomy 207V00000X
Also ListedOphthalmologyTaxonomy 207W00000X
Also ListedOrthopaedic SurgeryTaxonomy 207X00000X
Also ListedOtolaryngologyTaxonomy 207Y00000X
Also ListedPathology · Clinical Pathology/Laboratory MedicineTaxonomy 207ZP0105X
Also ListedPediatricsTaxonomy 208000000X
Also ListedPhysical Medicine & RehabilitationTaxonomy 208100000X
Also ListedSurgeryTaxonomy 208600000X
210 W 300 N 7-3, Roosevelt, UT 84066
Open in Google Maps ↗

Secondary Practice Locations 8

Location 115548 W 4000 WAltamont, UT 84001 · Phone (435) 454-3173 · Fax (435) 454-3990
Location 296 North 100 WestManila, UT 84046 · Phone (435) 784-3575 · Fax (435) 784-3505
Location 3405 N 500 WVernal, UT 84078-1907 · Phone (435) 789-4691 · Fax (435) 722-9291
Location 4175 N 200 W 102Vernal, UT 84078 · Phone (435) 789-4489
Location 5475 N 500 WVernal, UT 84078-1907 · Phone (435) 781-2030
Location 638080 West SR 35Tabiona Clinic, UT 84072 · Phone (435) 848-5509 · Fax (435) 848-5507
Location 750 E 200 SDuchesne, UT 84021 · Phone (435) 738-2426 · Fax (435) 738-2845
Location 8379 N 500 WVernal, UT 84078-1956 · Phone (435) 781-2030

Other Identifiers 1

Medicaid840276435084UT

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 BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah and more.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)

Northeastern Utah Medical Group is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

78

Medicare enrollment records show 78 clinicians reassign Medicare billing to Northeastern Utah Medical Group, which bills Medicare for the services they deliver. Of these, 7 practice within 10 miles. Listed here are the 20 practicing nearest to this location.

Clinicians by Medicare Specialty 22

Nurse Practitioner21
Family Practice14
Hematology/Oncology12
Internal Medicine5
General Surgery3
Medical Oncology3
Orthopedic Surgery3
Dermatology2
14 other specialties15

Nearest to this location (20)

See all 78
Rodney Anderson, M.D.
Family Practice
NPI 1952495582
379 NORTH 500 WEST SUITE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS1.3 mi
Karl Breitenbach, M.D.
Family Practice
NPI 1457447906
379 NORTH 500 WEST SUITE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS✔ Accepts Medicare1.3 mi
Michael Olsen, M.D.
Family Practice
NPI 1356437891
379 NORTH 500 WEST SUITE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS✔ Accepts Medicare1.3 mi
Kirk Woodward, M.D.
Family Practice
NPI 1811083348
379 NORTH 500 WEST SUITE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS✔ Accepts Medicare1.3 mi
Amy Olsen, FNP
Nurse Practitioner
NPI 1598991275
379 N 500 W STE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS✔ Accepts Medicare1.3 mi
Sarah Woody, FNP
Nurse Practitioner
NPI 1265720205
379 N 500 W STE 1A
Vernal, UT 84078
(435) 789-1165
✔ PECOS✔ Accepts Medicare1.3 mi
Alec Rimmasch, NP-C
Nurse Practitioner
NPI 1013346634
175 N 100 W STE 104
Vernal, UT 84078
(435) 781-3053
✔ PECOS1.3 mi
Annemarie Rousseau, APRN
Nurse Practitioner
NPI 1477075315
405 N 500 W BLDG 1
Vernal, UT 84078
(435) 722-5274
✔ PECOS✔ Accepts Medicare13 mi
Sandra Rust, A.P.R.N.
Nurse Practitioner
NPI 1992251268
285 E 100 S
Vernal, UT 84078
(435) 789-0064
✔ PECOS✔ Accepts Medicare13 mi
Steve Pehrson, M.D.
Family Practice
NPI 1164531968
6822 EAST 1000 SOUTH
Fort Duchesne, UT 84026
(435) 725-6874
✔ PECOS✔ Accepts Medicare19 mi
Whitney Gurr, APRN
Nurse Practitioner
NPI 1841027307
136 N 500 W
Roosevelt, UT 84066
(435) 722-4843
✔ PECOS✔ Accepts Medicare21 mi
Dallas Smuin, MD
Orthopedic Surgery
NPI 1659862555
250 W 300 N
Roosevelt, UT 84066
(435) 722-4691
✔ PECOS✔ Accepts Medicare24 mi
Lauren Bishop, MD
General Surgery
NPI 1861072795
250 W 300 N
Roosevelt, UT 84066
(435) 722-4691
✔ PECOS✔ Accepts Medicare25 mi
Trina Perras-Bird, FNP-C
Nurse Practitioner
NPI 1407787179
250 W 300 N
Roosevelt, UT 84066
(435) 722-4691
✔ PECOS25 mi
Jason Beales, MD
Pediatric Medicine
NPI 1891755872
210 W 300 N 75-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS25 mi
John Blake, MD
Dermatology
NPI 1508826587
210 W 300 N 7-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS✔ Accepts Medicare25 mi
Bradley Jenkins, FNP
Nurse Practitioner
NPI 1912968538
210 W 300 N 75-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS✔ Accepts Medicare25 mi
Lawrence Morrill, DO
General Practice
NPI 1497715593
210 W 300 N 75-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS✔ Accepts Medicare25 mi
John Nolte, MD
Obstetrics/Gynecology
NPI 1194786095
210 W 300 N 75-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS✔ Accepts Medicare25 mi
Shane Powell, MD
Ophthalmology
NPI 1750342655
210 W 300 N 75-3
Roosevelt, UT 84066
(435) 722-3971
✔ PECOS✔ Accepts Medicare25 mi
See all 78 clinicians

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 Northeastern Utah Medical Group's NPI number?

The NPI number for Northeastern Utah Medical Group is 1982664199. It was assigned to this organization in the NPPES registry on March 23, 2006.

Where is Northeastern Utah Medical Group located?

Northeastern Utah Medical Group is located at 210 W 300 N 7-3, Roosevelt, UT 84066. The listed phone number is (435) 722-3971.

What is Northeastern Utah Medical Group's specialty?

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

Is Northeastern Utah Medical Group enrolled in Medicare?

Yes. Northeastern Utah Medical Group is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Northeastern Utah Medical Group?

According to the CMS Revalidation Reassignment List (October 2026 release), 78 clinicians in 22 Medicare specialties reassign their Medicare billing to Northeastern Utah Medical Group. 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. The largest specialties are Nurse Practitioner (21), Family Practice (14) and Hematology/Oncology (12). Of these, 7 practice within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

What insurance does Northeastern Utah Medical Group accept?

Health plans from BridgeSpan Health Company, Molina Healthcare, Regence BlueCross BlueShield of Utah, Select Health and University of Utah Health Plans list Northeastern Utah Medical Group 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 Northeastern Utah Medical Group was last updated on October 23, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 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.