Northeastern Utah Medical Group
NPI 1982664199 · Family Medicine Physician · Roosevelt, UT
Provider details
- NPI number
- 1982664199
- Entity type
- Organization
- Primary specialty
- Family Medicine PhysicianAllopathic & Osteopathic Physicians
- Organization subpart
- No
- Authorized official
- Brent Hales, Cfo(435) 722-6164
Specialties & taxonomies
Allopathic & Osteopathic Physicians
- Internal Medicine Physician207R00000X
Allopathic & Osteopathic Physicians
- Pediatrics Physician208000000X
Allopathic & Osteopathic Physicians
- Surgery Physician208600000X
Allopathic & Osteopathic Physicians
- Orthopaedic Surgery Physician207X00000X
Allopathic & Osteopathic Physicians
- Ophthalmology Physician207W00000X
Allopathic & Osteopathic Physicians
Profile Score
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
20 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
9 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
Mailing address
Additional practice locations (8)
- 15548 W 4000 WAltamont, UT 84001Phone: (435) 454-3173Fax: (435) 454-3990
- 50 E 200 SDuchesne, UT 84021Phone: (435) 738-2426Fax: (435) 738-2845
- 96 North 100 WestManila, UT 84046Phone: (435) 784-3575Fax: (435) 784-3505
- 38080 West Sr 35Tabiona Clinic, UT 84072Phone: (435) 848-5509Fax: (435) 848-5507
- 475 N 500 WVernal, UT 84078-1907Phone: (435) 781-2030
- 379 N 500 WVernal, UT 84078-1956Phone: (435) 781-2030
- 175 N 200 W 102Vernal, UT 84078Phone: (435) 789-4489
- 405 N 500 WVernal, UT 84078-1907Phone: (435) 789-4691Fax: (435) 722-9291
Registry dates
- Enumerated
- 2006-03-23
- Last updated
- 2025-10-23
- Certified
- 2025-10-23
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.