NPIMap

Organization Active NPI

San Juan County Hospital

Doing business as San Juan Health

  • Emergency Care Clinic/Center
  • Monticello, UT
National Provider Identifier
1114121100
Registry record updated Jul 17, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Emergency Care Clinic/CenterTaxonomy code 261QE0002X
License
2006-HOSP-203 Issued in UT
Legal business name
SAN JUAN COUNTY HOSPITAL
Doing business as
San Juan Health
Practice address
380 West 100 North
Monticello, UT 84535-0308
Phone
(435) 587-1123
Fax
(435) 587-3016
NPI assigned
Jun 13, 2007
Last updated
Jul 17, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 2024

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

Authorized official

Name
Mr. Farley Crofts
Title
Cfo
Phone
(435) 587-1116

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Care Clinic/Center 261QE0002X 2006-HOSP-203 UT Primary

Addresses

Primary practice location

380 West 100 North
Monticello, UT 84535-0308

Mailing address

PO Box 308
Monticello, UT 84535-0308
Phone (435) 587-2116

Other names 1

  • San Juan Health Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040301000938 UT Part B Supplier - Clinic/Group Practice 4486541851 Receives reassigned benefits from 28 practitioners
4 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Monticello, UT; Spanish Valley, UT

Other NPIs on the same Medicare enrollment 4

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

National Provider Directory

National Provider Directory

Interoperability endpoints

  • FHIR API: https://fhir-myrecord.cerner.com/r4/d2bc3d5a-3c39-4553-86b1-b3aa0a5429a7/

Practitioners & affiliated clinicians

Practitioners 24

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 24

NPI Registry JSON

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

{
    "created_epoch": "1181692800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1721174400000",
    "number": "1114121100",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 308",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "845350308",
            "telephone_number": "435-587-2116",
            "fax_number": "435-587-2061"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "380 WEST 100 NORTH",
            "city": "MONTICELLO",
            "state": "UT",
            "postal_code": "845350308",
            "telephone_number": "435-587-1123",
            "fax_number": "435-587-3016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAN JUAN COUNTY HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-06-13",
        "last_updated": "2024-07-17",
        "certification_date": "2022-08-15",
        "status": "A",
        "authorized_official_last_name": "CROFTS",
        "authorized_official_first_name": "FARLEY",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "435-587-1116",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "261QE0002X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Emergency Care",
            "state": "UT",
            "license": "2006-HOSP-203",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "San Juan Health",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "San Juan Health",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Monticello, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.