NPIMap

Organization Active NPI

Intermountain Health Center, Inc.

  • Community/Behavioral Health Agency
  • Casa Grande, AZ
National Provider Identifier
1083315626
Registry record updated Feb 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
Legal business name
INTERMOUNTAIN HEALTH CENTER, INC.
Practice address
2028 N Trekell Rd Ste 102
Casa Grande, AZ 85122-1326
Phone
(520) 721-1887
Fax
(520) 721-0069
NPI assigned
Mar 10, 2023
Last updated
Feb 15, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 15, 2024

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

Authorized official

Name
Rose M Lopez, MBA
Title
President and Ceo
Phone
(520) 721-1887

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X Primary

Addresses

Primary practice location

2028 N Trekell Rd Ste 102
Casa Grande, AZ 85122-1326

Mailing address

PO Box 86537
Tucson, AZ 85754-6537
Phone (520) 721-1887

Other names 1

  • IHC Trekell Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in AZ

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190722003187 AZ Part B Supplier - Clinic/Group Practice 7113253659 Receives reassigned benefits from 24 practitioners
5 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Nogales, AZ; Casa Grande, AZ; Tucson, AZ

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Tax ID family
Ihc Broadway4 organizations share this tax ID, including this one

Other organizations with this tax ID 3

Organizations that report the same tax identification number in the National Provider Directory.

Locations

2028 N Trekell Rd
#10
Casa Grande, AZ 85122

2028 N Trekell Rd
Ste 1
Casa Grande, AZ 85122

272 W View Point Dr
Nogales, AZ 85621
Phone (520) 281-0678

1020 S Harrison Rd
Tucson, AZ 85748

3716 E Columbia St
Ste 120
Tucson, AZ 85714
Phone (520) 318-4882

5055 E Broadway Blvd
Ste C104
Tucson, AZ 85711
Phone (520) 623-9833

Practitioners & affiliated clinicians

Practitioners 22

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 22

NPI Registry JSON

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

{
    "created_epoch": "1678406400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1707955200000",
    "number": "1083315626",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 86537",
            "city": "TUCSON",
            "state": "AZ",
            "postal_code": "857546537",
            "telephone_number": "520-721-1887",
            "fax_number": "520-721-0069"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2028 N TREKELL RD STE 102",
            "city": "CASA GRANDE",
            "state": "AZ",
            "postal_code": "851221326",
            "telephone_number": "520-721-1887",
            "fax_number": "520-721-0069"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "INTERMOUNTAIN HEALTH CENTER, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-10",
        "last_updated": "2024-02-15",
        "certification_date": "2024-02-15",
        "status": "A",
        "authorized_official_last_name": "LOPEZ",
        "authorized_official_first_name": "ROSE",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "PRESIDENT AND CEO",
        "authorized_official_telephone_number": "520-721-1887",
        "authorized_official_credential": "MBA"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IHC Trekell",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "IHC Trekell",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Casa Grande, AZ

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2024; 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.