OrganizationActive
Living Tree Medical Group
NPI 1639754583 · Family Medicine Physician · Logan, UT
Provider details
- NPI number
- 1639754583
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Kris Coleman, Coc(435) 770-2131
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Health Service Clinic/Center261QH0100X
Ambulatory Health Care Facilities
Profile Score
Established profile(72/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
5 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
3 documented practice locations
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
1635 N 200 E
Logan, UT 84341-1913
Phone: (435) 565-6043
Fax: (435) 215-4420
Street-level locationGet directions
Mailing address
1635 N 200 E
Logan, UT 84341-1913
Additional practice locations (2)
- 1219 N 400 ELogan, UT 84341-2321Phone: (435) 565-6043Fax: (435) 215-4420
- 169 N Gateway Dr Ste 170Providence, UT 84332-9855Phone: (435) 565-6043Fax: (435) 215-4420
Registry dates
- Enumerated
- 2021-03-12
- Last updated
- 2025-07-11
- Certified
- 2025-07-11
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.