PRIMARY HEALTHCARE, PLLC – Primary Care Clinic/Center, NPI 1700503182

PRIMARY HEALTHCARE, PLLC is a healthcare provider. based in Murray, Utah. specializing in Primary Care Clinic/Center. The NPI Number for PRIMARY HEALTHCARE, PLLC is 1700503182

Main info

Organization
Name
PRIMARY HEALTHCARE, PLLC
NPI
1700503182
Phone
(801) 758-8735
Address
6095 S FASHION BLVD STE 220
Authorized Official
KEVIN MANGUM CEO/PHYSICIAN DO
Enumeration Date
26 October 2022
Last Update Date
2 June 2023
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience31
Completeness75
Years active:3State licenses:0Digital endpointsOther names

Provider Addresses for PRIMARY HEALTHCARE, PLLC

  • 6095 S FASHION BLVD STE 220

    MURRAY, UT 841077393

    Phone: (801) 758-8735

    Fax: (801) 769-3991

    Mailing address matches the actual address.

NPPES updates history

No NPPES updates recorded for this provider.

Prescription Activity

Loading prescription activity...

Open Payments (CMS)

No Open Payments data available for this provider.

This can happen when there are no reportable CMS Open Payments records.

Medicare Enrollment & Revalidation

Source: CMS public data · Not endorsed by CMS ·

Educational use only—not medical, billing, or legal advice.

PECOS enrollment status

Participating (accepts Medicare assignment)

Enrollment effective: 2023-10-20

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Revalidation scheduled

Earliest CMS due date is 2026-10-31 (143 days away).

Enrollment records

2

Earliest due date

2026-10-31

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20230208001581OClinic/Group PracticeUTTBD
O20231020001093OPhysician - Family PracticeUT2026-10-31

What to do next

  • Monitor the published due date as it approaches.
  • Plan to revalidate in PECOS within the window CMS allows before the due date.
  • Verify the date on the CMS Revalidation Lookup Tool before submitting.

Verify on CMS Revalidation Lookup Tool

Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS

Medicare Utilization (FFS)

Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·

Educational use only—not medical, billing, or legal advice.

No Medicare fee-for-service utilization data available for this provider in our database.

Insurance plans in this area (ZIP 84107)

Loading plans...

Reviews

All reviews are moderated before publication. Reviews reflect users' opinions; we do not verify the accuracy of individual reviews.

No reviews yet. Be the first to share your experience — your opinion helps families compare providers.

Frequently asked questions

Can I verify PRIMARY HEALTHCARE, PLLC with an NPI only?
You can start verification with NPI 1700503182 for PRIMARY HEALTHCARE, PLLC, then check state licensing separately.
Does CMS list PRIMARY HEALTHCARE, PLLC as active?
Yes — PRIMARY HEALTHCARE, PLLC is active in the NPI listing used on this page.
What is PRIMARY HEALTHCARE, PLLC's specialty?
The listing groups PRIMARY HEALTHCARE, PLLC with Primary Care Clinic/Center. Clinical services aligned with this taxonomy classification.
What address line appears for PRIMARY HEALTHCARE, PLLC?
PRIMARY HEALTHCARE, PLLC's geographic hint is Murray, Utah in our summary view.
Is the information about PRIMARY HEALTHCARE, PLLC up to date?
Data updates when providers file changes in NPPES — treat critical facts as "verify if unsure."

Similar Providers

ODYSSEY HOUSE INC

Substance Use Disorder Rehabilitation Clinic/Center
344 E 100 S STE 301
NPI: 1033143706

JAMES R.M. PEARCE M.D., LLC

Primary Care Clinic/Center
2185, 2100 East, Salt Lake City, Salt Lake County, Utah, 84109, United States
NPI: 1376708669

MURRAY FAMILY MEDICINE PLLC

Primary Care Clinic/Center
4815, South Center Street, Murray, Salt Lake County, Utah, 84107, United States
NPI: 1053773770

HolladayMD

Medical Specialty Clinic/Center
865 E 4800 S STE 160
NPI: 1255886990