NPIMap

Organization Active NPI

Mountainlands Community Health Center, Inc

  • Federally Qualified Health Center (FQHC)
  • Provo, UT
National Provider Identifier
1144829946
Registry record updated Mar 27, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC
Practice address
589 S State St
Provo, UT 84606-5056
Phone
(801) 294-2013
Fax
(801) 429-2002
NPI assigned
Oct 22, 2020
Organization subpart
Yes
Parent organization
MOUNTAINLANDS COMMUNITY HEALTH CENTER, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Mar 27, 2025

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

Authorized official

Name
Eric Johnson
Title
Financial Director
Phone
(801) 855-0091

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193400000X SINGLE SPECIALTY GROUP 122300000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

589 S State St
Provo, UT 84606-5056

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 855-0093

Other names 1

  • Mountainlands Community Health Center - Provo Dental Other name

National Provider Directory

National Provider Directory
Tax ID family
Mountainlands Family Pharmacy12 organizations share this tax ID, including this one
Part of
Mountainlands Family Pharmacy

Other organizations with this tax ID 11

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

Locations

299 E 900 S
Ste 100
Provo, UT 84606

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1603324800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1144829946",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-855-0093"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "589 S STATE ST",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846065056",
            "telephone_number": "801-294-2013",
            "fax_number": "801-429-2002"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC",
        "enumeration_date": "2020-10-22",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "JOHNSON",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "FINANCIAL DIRECTOR",
        "authorized_official_telephone_number": "801-855-0091"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Mountainlands Community Health Center - Provo Dental",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Mountainlands Community Health Center - Provo Dental",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 27, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.