NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Lehi Clinic

  • Clinic/Center
  • Lehi, UT
National Provider Identifier
1114422672
Registry record updated Jun 28, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinic/CenterTaxonomy code 261Q00000X
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Lehi Clinic
Practice address
3249 N 1200 W
Lehi, UT 84043-9772
Phone
(801) 234-5880
NPI assigned
Mar 27, 2018
Last updated
Jun 28, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 28, 2018

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

Authorized official

Name
Mark Briesacher, MD
Title
SVP-Chief Phys Exec/Pres Imgroup
Phone
(801) 442-3495

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinic/Center 261Q00000X NU Primary

Addresses

Primary practice location

3249 N 1200 W
Lehi, UT 84043-9772

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 716-1234

Other names 1

  • Lehi Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2152102Intermountain Lehi Clinic3249 North 1200 West, Lehi, UT 84043Certificate of waiverMay 22, 2027

National Provider Directory

National Provider Directory
Tax ID family
Robert E Fowles MD482 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

Locations

3903 Medical Dr
Ste 300
Ogden, UT 84403
Phone (801) 387-4930

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": "1522108800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1530144000000",
    "number": "1114422672",
    "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": "435-716-1234"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 N 1200 W",
            "city": "LEHI",
            "state": "UT",
            "postal_code": "840439772",
            "telephone_number": "801-234-5880"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-27",
        "last_updated": "2018-06-28",
        "status": "A",
        "authorized_official_last_name": "BRIESACHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP-CHIEF PHYS EXEC/PRES IMGROUP",
        "authorized_official_telephone_number": "801-442-3495",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Lehi Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Lehi Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Lehi, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 28, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.