Organization Active NPI

Ihc Health Services Inc

  • Community Based Hospice Care Agency
  • St George, UT
National Provider Identifier
1154496594
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Based Hospice Care AgencyTaxonomy code 251G00000X
Legal business name
IHC HEALTH SERVICES INC
Practice address
555 S Bluff St Ste 100
St George, UT 84770-7320
Phone
(435) 251-2367
NPI assigned
Nov 21, 2006
Organization subpart
No

Authorized official

NPPES NPI Registry
Name
Mark Provan
Title
VP-Homecare Hospice Palliative Care
Phone
(801) 442-2000

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

Affiliated clinicians 5

Clinicians who list this facility as an affiliation in Medicare Care Compare.

Care Compare: Hospice

Medicare Care Compare
Listed as
Intermountain Health Hospice - St. GeorgeCCN 461501
Ownership
Non-Profit
Certified
Feb 20, 1992
Medicare certification status
ActiveFrom the Provider of Services file

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
46D1101264Intermountain Health Hospice - St George555 S Bluff St, Suite 100, St George, UT 84770Certificate of waiverJun 23, 2027

Medicare participation

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

Hospice certification: CCN 461501

Legal name
IHC HEALTH SERVICES INC
Doing business as
INTERMOUNTAIN HEALTH HOSPICE - ST. GEORGE
Certification status
Active
Provider type (POS)
Hospice
Participating since
Feb 20, 1992
Last certification
Apr 6, 2022
Ownership / control type
Non-Profit - Private
Organization structure
CorporationNon-profit
Incorporated
Dec 10, 1982 in UT
Enrollment address
555 S Bluff St
Ste 100
St George, UT 84770-7320

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20090428000294 UT Part a Provider - Hospice 1850209420 Practice locations: Cedar City, UT; St George, UT

All disclosed owners & managing parties 14

Medicare enrollment files

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

NameRoleSinceShare
Shannon Cooke Baker Individual Corporate DirectorTrustee Jun 1, 2024
Robert Pettitt Individual Corporate DirectorTrustee Jun 7, 2023
Elizabeth Owens Individual Corporate DirectorTrustee Jun 1, 2024
William Caine Individual Corporate DirectorTrustee Jun 7, 2023
Patricia Ricks Individual Corporate DirectorTrustee Jun 1, 2024
Susan Robel Individual Corporate DirectorTrustee Apr 1, 2022
Deirdra Walsh Individual Corporate DirectorTrustee Jun 7, 2023
Robert Spendlove Individual Corporate DirectorTrustee Jun 1, 2024
Matt C Packard Individual Corporate DirectorBoard Member Jul 27, 2016
Riley Watts Individual Corporate OfficerFinance Director Jun 16, 2024
W-2 Managing EmployeeFinance Director Sep 16, 2024
Mark Provan Individual Corporate OfficerVP Homecare, Hospice, Palliative Ca Nov 13, 2023
Patricia K Ravert Individual Corporate DirectorBoard Member Oct 8, 2017 100%
William Hulterstrom Individual Corporate DirectorTrustee Jun 7, 2023
Robert W Allen Individual Corporate DirectorCeo Dec 1, 2022

All facility ownership & control disclosures 44

Medicare enrollment files

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

FacilityTypeRoleSince
Intermountain Health Cedar City HospitalCedar City, UT, CCN 460007 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1981
Mountain View HospitalIdaho Falls, ID, CCN 130065 Hospital 5% Or Greater Direct Ownership Interest (15%) Mar 31, 2023
Intermountain Health St George Regional HospitalSt George, UT, CCN 460021 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health McKay-Dee HospitalOgden, UT, CCN 460004 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Jan 1, 1976
Jan 1, 1976
Intermountain Health Sevier Valley HospitalRichfield, UT, CCN 460026 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Intermountain Health Bear River Valley HospitalTremonton, UT, CCN 460039 Hospital 5% Or Greater Direct Ownership Interest Jul 5, 1995
Intermountain Health Logan Regional HospitalLogan, UT, CCN 460015 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Intermountain Medical CenterMurray, UT, CCN 460010 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Alta View HospitalSandy, UT, CCN 460044 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 7, 1982
Intermountain Health American Fork HospitalAmerican Fork, UT, CCN 460023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health LDS HospitalSalt Lake City, UT, CCN 460006 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Orem Community HospitalOrem, UT, CCN 460043 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Primary Children'S HospitalSalt Lake City, UT, CCN 463301 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1980
Intermountain Health Utah Valley HospitalProvo, UT, CCN 460001 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Sanpete Valley HospitalMount Pleasant, UT, CCN 461303 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Cassia Regional HospitalBurley, ID, CCN 131326 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Delta Community HospitalDelta, UT, CCN 461300 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Fillmore Community HospitalFillmore, UT, CCN 461301 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Heber Valley HospitalHeber City, UT, CCN 461307 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Delta Community HospitalDelta, UT, CCN 46Z300 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 29, 2008
Intermountain Health Fillmore Community HospitalFillmore, UT, CCN 46Z301 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 9, 2008
Heber Valley HospitalHeber City, UT, CCN 46Z307 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Apr 1, 1975
Apr 1, 1975
Intermountain Medical Center-RehabilitationMurray, UT, CCN 46T010 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 7, 2007
Ihc Health Services IncSt George, UT, CCN 46T021 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Apr 1, 1975
Jan 1, 1976
McKay Dee HospitalOgden, UT, CCN 46T004 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control
Jan 1, 1976
Jan 1, 1976
Intermountain Health St George Regional HospitalProvo, UT, CCN 46T001 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Sanpete Valley HospitalMt Pleasant, UT, CCN 46Z303 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control
Apr 1, 1975
Apr 1, 1975
Intermountain Health Park City HospitalPark City, UT, CCN 460057 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Riverton HospitalRiverton, UT, CCN 460058 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 2, 2009
Intermountain Health Garfield Memorial HospitalPanguitch, UT, CCN 461333 Hospital Operational/Managerial Control Jan 1, 2017
Intermountain Health Garfield Memorial HospitalPanguitch, UT, CCN 46Z333 Hospital Operational/Managerial Control Jul 1, 2000
Intermountain Health Layton HospitalLayton, UT, CCN 460061 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Idaho Falls Community Hospital LLCIdaho Falls, ID, CCN 130074 Hospital 5% Or Greater Direct Ownership Interest (20%) Mar 31, 2023
Intermountain Health Spanish Fork HospitalSpanish Fork, UT, CCN 460062 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Cassia Regional HospitalBurley, ID, CCN 13Z326 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Logan Regional Hospital Transitional Care UnitLogan, UT, CCN 465123 Skilled nursing facility Operational/Managerial Control Jul 29, 2008
Intermountain Health Home Health - Mt. PleasantMount Pleasant, UT, CCN 467016 Home health agency 5% Or Greater Direct Ownership Interest (100%) Aug 1, 1980
Intermountain Health Home Health - OgdenOgden, UT, CCN 467004 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Intermountain Health Home Health - St. GeorgeSt George, UT, CCN 467033 Home health agency 5% Or Greater Direct Ownership Interest (100%) Mar 25, 2009
Intermountain Health Hospice - LoganLogan, UT, CCN 461504 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2009
Garfield Memorial HospitalPanguitch, UT, CCN 463984 Rural health clinic Operational/Managerial Control Jan 21, 2010
Garfield CountyCircleville, UT, CCN 463980 Rural health clinic Operational/Managerial Control Apr 26, 2010
Bryce Valley ClinicCannonville, UT, CCN 463981 Rural health clinic Operational/Managerial Control Apr 26, 2010
Upper Valley FamilymedicineRigby, ID, CCN 138538 Rural health clinic 5% Or Greater Direct Ownership Interest Apr 7, 2025

National Provider Directory

National Provider Directory
Tax ID family
Bradley S Thompson DO479 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

Specialties & licenses 1

NPPES NPI Registry
Specialty (taxonomy)CodeLicenseStatePrimary
Community Based Hospice Care Agency 251G00000X Primary

Addresses

NPPES NPI Registry

Primary practice location

555 S Bluff St Ste 100
St George, UT 84770-7320

Mailing address

11520 S Redwood Rd
South Jordan, UT 84095-7805
Phone (385) 887-6000

Other identifiers 1

NPPES NPI Registry
IdentifierTypeStateIssuer
1154496594MedicaidUT

Other names 2

NPPES NPI Registry
  • Intermountain Health Hospice Cedar City Doing business as
  • Intermountain Health Hospice St. George Doing business as

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jan 29, 2025.

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1154496594",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957805",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "555 S BLUFF ST STE 100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847707320",
            "telephone_number": "435-251-2367"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "PROVAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP-HOMECARE HOSPICE PALLIATIVE CARE",
        "authorized_official_telephone_number": "801-442-2000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1154496594",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Hospice Cedar City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice St. George",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

Verify at the official NPI Registry.