Organization Active NPI

Affinity Healthcare, Inc.

  • Family Medicine Physician
  • Logan, UT
National Provider Identifier
1144928854
Registry record updated Dec 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
AFFINITY HEALTHCARE, INC.
Practice address
93 East 200 South
Suite 210-B
Logan, UT 84321
Phone
(435) 276-0888
Fax
(833) 471-4536
NPI assigned
Feb 21, 2023
Last updated
Dec 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2025

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

Authorized official

Name
Laval B Jensen
Title
Ceo
Phone
(435) 276-0888

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

93 East 200 South
Suite 210-B
Logan, UT 84321

Mailing address

2380 N 400 E Ste B
North Logan, UT 84341-1756
Phone (435) 276-0888

Other identifiers 2

IdentifierTypeStateIssuer
3006721MedicaidUT
4201995MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230320000395 UT Part B Supplier - Clinic/Group Practice 2062886815 Receives reassigned benefits from 2 practitioners
Practice locations: Logan, UT

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
46D2279100Affinity Healthcare Inc93 East 200 South, Suite 210-B, Logan, UT 84321Certificate of waiverMar 28, 2027

National Provider Directory

National Provider Directory

Locations

93 E 200 S
Ste 210B
Logan, UT 84321
Phone (435) 276-0888

Practitioners & affiliated clinicians

Practitioners 4

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": "1676937600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1766966400000",
    "number": "1144928854",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2380 N 400 E STE B",
            "city": "NORTH LOGAN",
            "state": "UT",
            "postal_code": "843411756",
            "telephone_number": "435-276-0888"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "93 EAST 200 SOUTH",
            "address_2": "SUITE 210-B",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "84321",
            "telephone_number": "435-276-0888",
            "fax_number": "833-471-4536"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "AFFINITY HEALTHCARE, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-21",
        "last_updated": "2025-12-29",
        "certification_date": "2025-12-29",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "LAVAL",
        "authorized_official_middle_name": "B",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-276-0888"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "3006721",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "4201995",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2025; 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.