| Colten Dirk Bracken, MD | |
|
571 East Main Street, Enterprise, UT 84725 | |
| (435) 878-5711 | |
| (435) 878-5712 |
| Full Name | Colten Dirk Bracken |
|---|---|
| Gender | Male |
| Speciality | Family Practice |
| Experience | 11 Years |
| Location | 571 East Main Street, Enterprise, Utah |
| Accepts Medicare Assignments | Yes. He accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1073993283 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 9832788-1205 (Utah) | Primary |
| Facility Name | Location | Facility Type |
|---|---|---|
| Zion's Way Home Health | St. george, UT | Home health agency |
| Zion's Way Hospice | St george, UT | Hospice |
| Grover C Dils Medical Center | Caliente, NV | Hospital |
| Intermountain Health St George Regional Hospital | St george, UT | Hospital |
| Intermountain Health Garfield Memorial Hospital | Panguitch, UT | Hospital |
| Intermountain Health Cedar City Hospital | Cedar city, UT | Hospital |
| Group Practice Name | Group PECOS PAC ID | No. of Members |
|---|---|---|
| Revere Health Pc | 7517868508 | 407 |
| Lincoln County Hospital District | 2163408246 | 11 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1629260880 PECOS PAC ID: 1850209420 Enrollment ID: O20031105000079 |
| Entity Name | Revere Health PC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1093764805 PECOS PAC ID: 7517868508 Enrollment ID: O20040113000805 |
| Entity Name | Ihc Health Services Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1942325154 PECOS PAC ID: 1850209420 Enrollment ID: O20080610000303 |
| Entity Name | Main Street Family Medicine PLLC |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1518636844 PECOS PAC ID: 0547650962 Enrollment ID: O20211129001703 |
| Mailing Address | Practice Location Address |
|---|---|
| Colten Dirk Bracken, MD 1055 N 500 W, Provo, UT 84604-3305 Ph: (801) 354-8225 | Colten Dirk Bracken, MD 571 East Main Street, Enterprise, UT 84725 Ph: (435) 878-5711 |