CUSTOM MEDICAL SERVICES
CUSTOM MEDICAL SERVICES is an organization registered with the National Plan and Provider Enumeration System (NPPES) under NPI 1669452298, based in Roosevelt, UT. The organization lists 4 taxonomy classifications, with Adolescent Medicine (Family Medicine) Physician recorded as primary.
Getting there
The practice address on file is RR 3 BOX 3053, Roosevelt, UT 84066. We have not yet mapped what surrounds this office — parking, transit, and nearby pharmacies are added as our data collection reaches each location.
Credentials and Medicare
| Licence | State | Specialty |
|---|---|---|
| V09531 | UT | Legal Medicine |
| V09531 | UT | Adult Medicine Physician |
This provider holds licence V09531 issued in UT. A licence number in NPPES reflects what was filed at registration — it does not confirm the licence is still active today.
This NPI does not appear in the PECOS Medicare enrolment file. Providers who do not bill Medicare — or who bill only through a group's enrolment — will not appear here. It is not a sign of any problem with the registration.
What Adolescent Medicine covers
A family medicine physician with multidisciplinary training in the unique physical, psychological and social characteristics of adolescents and their health care problems and needs. NUCC Health Care Provider Taxonomy, code 207QA0000X
All registered taxonomy codes
This provider registers 4 taxonomy codes. The primary code is what appears on most claims; the others record additional recognised specialties.
| Code | Specialty | Licence | State | |
|---|---|---|---|---|
| 207QA0000X | Adolescent Medicine (Family Medicine) Physician Adolescent Medicine | — | — | primary |
| 173000000X | Legal Medicine | V09531 | UT | |
| 207QA0505X | Adult Medicine Physician Adult Medicine | V09531 | UT | |
| 207QG0300X | Geriatric Medicine (Family Medicine) Physician Geriatric Medicine | — | — |
The taxonomy records how the provider classifies their own practice. It does not confirm which conditions they currently treat, whether they are accepting new patients, or which insurance they take — call the office for that.
Full NPPES record
An NPI-2 identifies an organization — a clinic, hospital, group practice, laboratory, or supplier. Individual clinicians working there hold their own NPI-1 numbers separately, so a bill may reference both.
| NPI | 1669452298 valid check digit |
|---|---|
| Entity type | Organization (NPI-2) |
| Enumeration date | Jan 19, 2006 |
| Last updated | Sep 11, 2025 |
| Status | Active |
| Practice address |
RR 3 BOX 3053 Roosevelt, UT 84066 (435) 722-7704 |
Number check
How the check works, step by step
Every NPI carries a Luhn check digit — the same scheme used on credit cards. CMS prefixes the number with 80840 before computing it, which marks it as a US health identifier.
| Digit | 8 | 0 | 8 | 4 | 0 | 1 | 6 | 6 | 9 | 4 | 5 | 2 | 2 | 9 |
|---|---|---|---|---|---|---|---|---|---|---|---|---|---|---|
| Doubled? | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 | — | ×2 |
| Value | 8 | 0 | 8 | 8 | 0 | 2 | 6 | 3 | 9 | 8 | 5 | 4 | 2 | 9 |
Sum = 72 · next multiple of 10 = 80 · check digit = 8 · actual last digit = 8
A valid check digit only means the number is well-formed. It does not mean the provider is licensed, active, or in good standing — those are separate questions answered by the sections above.