Main Street Family Medicine PLLC
NPI 1518636844ActiveOrganization· Family Medicine· Enterprise, UT
Family Medicine in Enterprise, Utah, registered in NPPES in September 2021. The authorized official on file is Colten Dirk Bracken, MD, Md/Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1518636844 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | Sep 9, 2021 |
| Last updated in NPPES | Oct 29, 2021 |
| Certified by provider | Oct 29, 2021 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| Family Medicine Primary | 207Q00000X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Nov 10, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 11, 2026 | No match | — |
| New York OMIG · Nov 11, 2026 | No match | — |
| Ohio Medicaid · Nov 11, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 11, 2026 | No match | — |
| Washington HCA · Nov 11, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
Other Family Medicine providers in Enterprise
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