Healthcare Provider Details

I. General information

NPI: 1497553978
Provider Name (Legal Business Name): CACHE VALLEY MIDWIFERY GROUP
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/03/2025
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2380 N 400 E STE D
LOGAN UT
84341-1756
US

IV. Provider business mailing address

2885 S 5900 W
MENDON UT
84325-9789
US

V. Phone/Fax

Practice location:
  • Phone: 435-770-5627
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261QB0400X
TaxonomyBirthing Clinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code367A00000X
TaxonomyAdvanced Practice Midwife
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: JAMESON HEPNER
Title or Position: MANAGER
Credential:
Phone: 435-232-3286