Utah Modern Medical LLC
NPI 1689310948ActiveOrganization· General Practice· Lehi, UT
General Practice in Lehi, Utah, registered in NPPES in May 2022. The authorized official on file is Dave Bullock, Owner. Enrolled in Medicare as part b supplier - clinic/group practice.
Overview
| NPI | 1689310948 |
|---|---|
| Status | Active |
| Entity type | Organization |
| NPI issued | May 10, 2022 |
| Last updated in NPPES | Sep 17, 2026 |
| Certified by provider | Sep 17, 2026 |
Specialties and licenses
| Taxonomy | Code | License | State |
|---|---|---|---|
| General Practice Primary | 208D00000X | — | — |
| Family Medicine | 207Q00000X | — | — |
| Physician Assistant, Medical | 363AM0700X | — | — |
Exclusion screening
| List | Result | Details |
|---|---|---|
| HHS-OIG LEIE · Oct 9, 2026 | No match | Checked by NPI and by name + state |
| North Carolina Medicaid · Nov 4, 2026 | No match | — |
| New York OMIG · Nov 4, 2026 | No match | — |
| Ohio Medicaid · Nov 4, 2026 | No match | — |
| Pennsylvania Medicheck · Nov 4, 2026 | No match | — |
| Washington HCA · Nov 4, 2026 | No match | — |
Official OIG search · How matching works ·Bulk check a roster
Medicare
| Enrollment (PECOS) | Enrolled Part B Supplier - Clinic/Group Practice (UT) |
|---|
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