Active NPI
Health Watch Provo Inc
- Home Health Agency
- Orem, UT
National Provider Identifier
1093763427
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Home Health Agency
- License
- 2005-HHA-825
- Legal business name
- HEALTH WATCH PROVO INC
- Practice address
- 1485 E 840 N
Orem, UT 84097-5486 - Phone
- (801) 225-0599
- NPI assigned
- May 5, 2006
- Last updated
- Oct 20, 2016
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Kaye Lopez
- Title
- Owner
- Phone
- (801) 225-0599
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Home Health Agency | 251E00000X | 2005-HHA-825 | UT | Primary |
Addresses
Primary practice location
1485 E 840 N
Orem, UT 84097-5486
Mailing address
9152 Silver Lake Dr
Cedar Hills, UT 84062-8787
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20040525000834 | UT | Part A Provider - Home Health Agency | 7911988126 | Practice locations: Orem, UT |
NPI to CCN mapping 1
The Medicare certification numbers (CCNs) connected to NPI 1093763427. Details of each certification follow.
Home health agency certification: CCN 467106
- Legal name
- HEALTH WATCH PROVO INC.
- Certification status
- Active
- Provider type (POS)
- Home health agency
- Participating since
- Oct 15, 1996
- Last certification
- May 18, 2021
- Ownership / control type
- Proprietary
- Organization structure
- Corporation
- Incorporated
- Oct 1, 1996 in UT
- Enrollment address
- 1485 E 840 N
Orem, UT 84097-5486
Care Compare: Home health agency
Medicare Care Compare- Listed as
- Health Watch Provo, Inc.
- Overall star rating
- Ownership
- Proprietary
- Certified
- Oct 15, 1996
- Medicare certification status
- Active
- Services
- Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy
National Provider Directory
National Provider Directory- Tax ID family
- Health Watch Provo Inc
Other organizations with this tax ID 1
Organizations that report the same tax identification number in the National Provider Directory.
-
- Public Health or Welfare Agency
- Orem, UT
- NPI 1184029639
Locations
466 N Main St
Ste 204
Clearfield, UT 84015
Phone (801) 771-3964
930 W 410 N
Lindon, UT 84042
Phone (801) 225-0599
3293 Harrison Blvd
Ste 110
Ogden, UT 84403
Phone (801) 771-3964
Networks
- UT PPO
Ownership & related parties
All disclosed owners & managing parties 4
As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.
| Name | Role | Since | Share |
|---|---|---|---|
| Trudy L Northcutt | Corporate Officer | May 1, 2017 | |
| Mark Lopez | W-2 Managing Employee | May 1, 2017 | |
| Carl R Lopez | 5% Or Greater Direct Ownership Interest | Oct 1, 1996 | 50% |
| Corporate Director | Oct 1, 1996 | ||
| Kaye N Lopez | 5% Or Greater Direct Ownership Interest | Oct 1, 1996 | 50% |
| Corporate Officer | Oct 1, 1996 | ||
| Corporate Director | Oct 1, 1996 |
Practitioners & affiliated clinicians
Affiliated clinicians 13
Clinicians who list this facility as an affiliation in Medicare Care Compare.
-
- Family Nurse Practitioner
- Payson, UT
- NPI 1841808375
Home health agency
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1146787200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1476921600000",
"number": "1093763427",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9152 SILVER LAKE DR",
"city": "CEDAR HILLS",
"state": "UT",
"postal_code": "840628787"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1485 E 840 N",
"city": "OREM",
"state": "UT",
"postal_code": "840975486",
"telephone_number": "801-225-0599"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "HEALTH WATCH PROVO INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-05-05",
"last_updated": "2016-10-20",
"status": "A",
"authorized_official_last_name": "LOPEZ",
"authorized_official_first_name": "KAYE",
"authorized_official_title_or_position": "OWNER",
"authorized_official_telephone_number": "801-225-0599"
},
"taxonomies": [
{
"code": "251E00000X",
"taxonomy_group": "",
"desc": "Home Health",
"state": "UT",
"license": "2005-HHA-825",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Orem, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 20, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.