OrganizationActive
Northeastern Utah Medical Group
NPI 1316316482 · Physician Assistant · Roosevelt, UT
Provider details
- NPI number
- 1316316482
- Entity type
- Organization
- Primary specialty
- Physician AssistantPhysician Assistants & Advanced Practice Nursing Providers
- Parent organization
- Uintah Basin Medical Center
- Organization subpart
- Yes
- Authorized official
- James Marshal, Ceo(435) 722-6162
- License
- 6411766-1206 (UT)
Specialties & taxonomies
Physician Assistants & Advanced Practice Nursing Providers
Profile Score
Established profile(73/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
10 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
250 W 300 N
Roosevelt, UT 84066-2336
Phone: (435) 722-4691
Fax: (435) 722-9291
Street-level locationGet directions
Mailing address
250 W 300 N
Roosevelt, UT 84066-2336
Registry dates
- Enumerated
- 2015-09-18
- Last updated
- 2015-09-18
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.