NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Northern Utah Surgeons

  • Surgery Physician
  • Ogden, UT
National Provider Identifier
1053456764
Registry record updated Sep 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Surgery PhysicianTaxonomy code 208600000X
License
1002294 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Northern Utah Surgeons
Practice address
4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277
Phone
(801) 387-7450
NPI assigned
Feb 20, 2007
Last updated
Sep 1, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Sep 1, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Dr. Mark Briesacher, MD
Title
SVP-Chief Phys Executive
Phone
(801) 442-3495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Surgery Physician 208600000X 1002294 UT Primary

Addresses

Primary practice location

4403 Harrison Blvd Ste 2600
Ogden, UT 84403-3277

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 387-7450

Other names 1

  • Northern Utah Surgeons Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20031105000079 UT Part B Supplier - Clinic/Group Practice 1850209420 Receives reassigned benefits from 1,923 practitioners
This NPI is an additional NPI on the enrollment
O20080610000303 UT Part B Supplier - Clinic/Group Practice 1850209420 Receives reassigned benefits from 4,146 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Locations

1333 N Main St
Ste 1
Cedar City, UT 84721
Phone (435) 858-5576

4403 Harrison Blvd
#7742
Ogden, UT 84403
Phone (801) 387-7450

4403 Harrison Blvd
Ste V1635
Ogden, UT 84403

324 Tenth Ave
Ste 200
Salt Lake City, UT 84103
Phone (801) 355-9951

Practitioners & affiliated clinicians

Practitioners 11

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171929600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1630454400000",
    "number": "1053456764",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-387-7450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4403 HARRISON BLVD STE 2600",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844033277",
            "telephone_number": "801-387-7450"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-20",
        "last_updated": "2021-09-01",
        "certification_date": "2021-09-01",
        "status": "A",
        "authorized_official_last_name": "BRIESACHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP-CHIEF PHYS EXECUTIVE",
        "authorized_official_telephone_number": "801-442-3495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "1002294",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Northern Utah Surgeons",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Northern Utah Surgeons",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ogden, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 1, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.