Healthcare Provider Details

I. General information

NPI: 1407763865
Provider Name (Legal Business Name): GUARDIAN SPORTS MEDICINE & FAMILY HEALTH
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/24/2026
Last Update Date: 08/24/2026
Certification Date: 08/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 SOUTH INTERSTATE DR SUITE 201
CEDAR CITY UT
84720
US

IV. Provider business mailing address

3894 W 1225 N
CEDAR CITY UT
84721-8399
US

V. Phone/Fax

Practice location:
  • Phone: 614-598-9258
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207QS0010X
TaxonomySports Medicine (Family Medicine) Physician
License Number
License Number State

VIII. Authorized Official

Name: NATHANIEL NYE
Title or Position: OWNER
Credential:
Phone: 614-598-9258