Ihc Health Services Inc
Organization Active NPI Obstetrics & Gynecology Physician · St George, UT
NPI 1134428279 · NPPES record last updated Jan 7, 2021
Key facts
- NPI
- 1134428279
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Obstetrics & Gynecology Physician 207V00000X
- License
- 3182011 (UT)
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 1380 E Medical Center Dr Ste 1600
St George, UT 84790-2123 - Phone
- (435) 251-4170
- NPI assigned
- Mar 15, 2011
- Organization subpart
- No
Authorized official
- Name
- Mark Briesacher, MD
- Title
- SVP Chief Phys Exec/Pres Im Group
- Phone
- (801) 442-3495
Corporate family (same tax ID) 24
Practitioners 8
-
Tyson James Carter, D.P.M.
-
Dixi L Haramoto, APRN, FNP-C
-
Brecken Tristin Jackson, APRN
-
Brian K. Penrose, DPM
-
Tiina M Thorley, MPA, PA-C, RRT
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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 |
National Provider Directory
- Tax ID family
- Bradley S Thompson DO
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Obstetrics & Gynecology Physician |
207V00000X | 3182011 | UT | Yes |
Addresses
Primary practice location
1380 E Medical Center Dr Ste 1600
St George, UT 84790-2123
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 688-4770
Other practice location 1
544 S 400 E
St George, UT 84770-3705
Phone (435) 688-4770
Other names
- Dixie MFM High Risk OB
- St George High Risk OB
Other providers in St George, UT
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
All providers in St George, UT · Obstetrics & Gynecology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.