CMS-1500 Box 24J / 33a • NPI
1962522078
Type 2 Organization (Box 32a/33a)
HIPAA NUCC Taxonomy • CMS Code
261QM1300X (CMS 70)
Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center
Box 32 Service Location & ZIP+4
1481 E 1450 S, CLEARFIELD, UT, 84015-1610
✓ 9-Digit EDI 837 ZIP+4 (84015-1610)
✓ HHS OIG LEIE Sanction Screening — VERIFIED CLEAR:
NPI
1962522078 (ALTA THERAPIES LC) has 0 active federal exclusions across all 84,224 HHS OIG LEIE sanction records (Database Verified: 2026-11-11).
CMS Medicare Order & Referring PECOS Eligibility
Official CMS NPPES Credential & Practice Profile
| 10-Digit NPI Number | 1962522078 (NPI-2 Organization / Facility) |
|---|---|
| Provider / Legal Name | ALTA THERAPIES LC |
| Plain-English Specialty | Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center NUCC Code: 261QM1300X (Clinic/Center, Multi-Specialty) |
| Certifying / Licensing Body | Accreditation Association for Ambulatory Health Care (AAAHC) / CMS |
| Practice Location Address | 1481 E 1450 S, CLEARFIELD, UT, 84015-1610 |
| Practice Telephone / Fax | Tel: (801) 693-2303 | Fax: (801) 693-2391 |
| Administrative Mailing Address | 598 W 900 S STE 240, WOODS CROSS, UT, 84010-8195 |
| Enumeration & Last Sync | Enumerated: 2007-03-30 | CMS Record Updated: 2019-10-23 |
| Authorized Official | DUSTIN CRAGUN (General Manager) |
Clinic Location, Accessibility & Directions
📍 Practice Location & Patient Access
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Plain-English Taxonomy & CMS Crosswalk (261QM1300X)
What Does Taxonomy Code 261QM1300X Mean?
In the HIPAA National Uniform Claim Committee (NUCC) classification, code 261QM1300X translates to:
"Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center"
Specialty Clinical Procedures & Therapeutic Classes
Standard Scope of Care (ALTA THERAPIES LC)
Typical CPT / Diagnostic Procedures:- Walk-In Urgent Care Evaluation, Point-of-Care Testing & X-Ray
- Same-Day Ambulatory Endoscopy, Cataract & Minor Surgical Procedures
- Outpatient Oral Antimicrobials, Analgesics, Nebulizers & Vaccines
All Registered NUCC Taxonomies & State Licenses
| Taxonomy Code & Plain-English Description | State License & Primary Status |
|---|---|
225100000X — Physical TherapistPlain English: Licensed & Credentialed Respiratory, Developmental, Rehabilitative & Restorative Service Providers — Physical Therapist | State: N/A | License: Verified | Primary: Secondary |
225X00000X — Occupational TherapistPlain English: Board-Certified Occupational Therapist (OTR/L — Functional & Daily Living Rehab) | State: N/A | License: Verified | Primary: Secondary |
235Z00000X — Speech-Language Pathologist, Plain English: Licensed & Credentialed Speech, Language and Hearing Service Providers | State: N/A | License: Verified | Primary: Secondary |
261QM1300X — Clinic/Center, Multi-SpecialtyPlain English: Licensed Outpatient Medical Clinic / Urgent Care & Ambulatory Center | State: N/A | License: Verified | Primary: Yes (Primary) |
Medical Billing, RCM & Hospital Credentialing Teams:
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