Richard Thomas Stevens (NPI# 1790739449, PAC ID# 6709889033) is a physician enrolled in Centers for Medicare & Medicaid Services (CMS). The primary specialty is FAMILY MEDICINE.
| Nation Provider ID (NPI) | 1790739449 |
| PAC ID by PECOS | 6709889033 |
| Professional Enrollment ID | I20060807000142 |
| Full Name | Richard Thomas Stevens |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-CACHE VALLEY LLC |
| Address |
382 W 280 Providence UT 84332-9753 |
| Phone Number | 4357520330 |
| Gender | M |
| Credential | MD |
| Medical School | MEDICAL COLLEGE OF WISCONSIN |
| Graduation Year | 2003 |
| Primary Specialty | FAMILY MEDICINE |
| Group Practice PAC ID | 5193887149 |
| Number of Group Practice Members | 7 |
| Accepts Medicare Assignment | Y |
| Claim Control Number (CCN) | Legal Business Name |
|---|---|
| 460054 | CACHE VALLEY HOSPITAL |
| 460015 | LOGAN REGIONAL HOSPITAL |
| Address | Phone | Organization |
|---|---|---|
| 382 W 280, Providence, UT 84332-9753 | 4357520330 | MOUNTAINSTAR MEDICAL GROUP-CACHE VALLEY LLC |
| Organization Legal Name | MOUNTAINSTAR MEDICAL GROUP-CACHE VALLEY LLC |
| Physicians | 6 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin R Duke | Family Medicine | Mountainstar Medical Group-cache Valley LLC | 382 W 280, Providence, UT 84332-9753 |
| Matthew J Welter | Family Medicine | Mountainstar Medical Group-cache Valley LLC | 2380 N 400, Suite A, North Logan, UT 84341-1756 |
| Mark Traveller Hansen | General Surgery | Mountainstar Medical Group-cache Valley LLC | 2380 N 400, Suite A, North Logan, UT 84341-1756 |
| Nathan R Bertoldo | Obstetrics/gynecology | Mountainstar Medical Group-cache Valley LLC | 2380 N 400, North Logan, UT 84321 |
| Lars Bergeson | Family Practice | Mountainstar Medical Group-cache Valley LLC | 382 W 280, Providence, UT 84332-9753 |
| Street Address |
382 W 280 |
| City | PROVIDENCE |
| State | UT |
| Zip | 84332-9753 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Kevin R Duke | Family Medicine | Mountainstar Medical Group-cache Valley LLC | 382 W 280, Providence, UT 84332-9753 |
| Lars Bergeson | Family Practice | Mountainstar Medical Group-cache Valley LLC | 382 W 280, Providence, UT 84332-9753 |
| Name | Specialty | Organization | Address |
|---|---|---|---|
| Spencer W Wade | Chiropractic | 565 W 465 N, Suite 140, Providence, UT 84332-4802 | |
| Vera Carlson | Family Medicine | 565 W 465, Suite 130, Providence, UT 84332-4802 | |
| Corey B Johnson | Emergency Medicine | 565 W 465 N, 130 Cache Vein Care, Providence, UT 84332-4802 | |
| Thomas Owen Fullmer X | Chiropractic | 1652s Hwy 165, Providence, UT 84332-6701 | |
| Nichole L Jardine | Clinical Social Worker | 545 W 465, Suite 130, Providence, UT 84332-8005 | |
| Thomas E Atkin | Clinical Psychologist | 545 W 465 N, Providence, UT 84332-8005 | |
| Jeremy William Broadhurst | Family Medicine | Ihc Health Services Inc | 190 S Hwy 165, Providence, UT 84332-9512 |
| Robert G Patterson | Family Medicine | Ihc Health Services Inc | 190 S Hwy 165, Providence, UT 84332-9512 |
| David A Smith | Optometry | 276 N Spring Creek Pkwy, Providence, UT 84332-9775 | |
| Steven S Garvert | Chiropractic | Springcreek Medical Center PC | 267 N Spring Creek Pkwy, Providence, UT 84332-9775 |
| Find all physicians in zip 84332 | |||
| City | PROVIDENCE |
| Zip Code | 84332 |
| Specialty | FAMILY MEDICINE |
| City + Specialty | PROVIDENCE + FAMILY MEDICINE |
Please comment or provide details below to improve the information on Richard Thomas Stevens.
| Data Provider | Centers for Medicare & Medicaid Services (CMS) |
| Jurisdiction | Medicare |
This dataset includes 1.12 million groups, individual physicians, and other clinicians currently enrolled in Medicare. Each physician is registered with NPI, PAC ID, full name, specialty, phone, organization, hospital, address, medical school, etc.