NPIMap

Organization Active NPI

Midtown Community Health Center Inc

Doing business as MTCHC Logan Clinic

  • Federally Qualified Health Center (FQHC)
  • Logan, UT
National Provider Identifier
1053780171
Registry record updated Nov 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MIDTOWN COMMUNITY HEALTH CENTER INC
Doing business as
MTCHC Logan Clinic
Practice address
550 E 1400 N Ste Xy
Logan, UT 84341-2406
Phone
(801) 393-5355
Fax
(801) 394-4609
NPI assigned
Sep 18, 2015
Last updated
Nov 30, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 30, 2018

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

Authorized official

Name
Sonja Levesque
Title
Cfo
Phone
(801) 334-1327

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Community Health Clinic/Center 261QC1500X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

550 E 1400 N Ste Xy
Logan, UT 84341-2406

Mailing address

550 E 1400 N Ste Xy
Logan, UT 84341-2406
Phone (801) 393-5355

Other names 1

  • MTCHC Logan Clinic Doing business as

National Provider Directory

National Provider Directory

Locations

525 E Datc Dr
Kaysville, UT 84037
Phone (801) 402-0581

425 E 5350 S
Ste 355
Ogden, UT 84405
Phone (801) 475-7007

670 28th St
Ogden, UT 84403
Phone (801) 393-5355

Practitioners & affiliated clinicians

Practitioners 42

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.

View all 42

NPI Registry JSON

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

{
    "created_epoch": "1442534400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543536000000",
    "number": "1053780171",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "550 E 1400 N STE XY",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 1400 N STE XY",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412406",
            "telephone_number": "801-393-5355",
            "fax_number": "801-394-4609"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIDTOWN COMMUNITY HEALTH CENTER INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-09-18",
        "last_updated": "2018-11-30",
        "status": "A",
        "authorized_official_last_name": "LEVESQUE",
        "authorized_official_first_name": "SONJA",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "801-334-1327"
    },
    "taxonomies": [
        {
            "code": "261QC1500X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Community Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "MTCHC Logan Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "MTCHC Logan Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.