NPIMap

Organization Active NPI

Mountainlands Community Health Center, Inc.

  • Federally Qualified Health Center (FQHC)
  • Vernal, UT
National Provider Identifier
1154739787
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
133 S 500 E
Suite 101
Vernal, UT 84078-2728
Phone
(435) 789-2024
Fax
(435) 789-2034
NPI assigned
Jul 28, 2014
Last updated
Mar 27, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNTAINLANDS COMMUNITY HEALTH CENTERAs 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
Mr. Todd Bailey, MBA, CMPE
Title
Executive Director
Phone
(801) 429-2000

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Dental Clinic/Center 261QD0000X 138432-9922 UT
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

133 S 500 E
Suite 101
Vernal, UT 84078-2728

Mailing address

589 S State St
Provo, UT 84606-5056
Phone (801) 429-2000

National Provider Directory

National Provider Directory
Tax ID family
Mountainlands Family Pharmacy - Wasatch12 organizations share this tax ID, including this one
Part of
Mountainlands Family Pharmacy - Wasatch

Other organizations with this tax ID 11

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

Locations

133 S 500 E
Ste 101
Vernal, UT 84078
Phone (435) 789-2024

Interoperability endpoints

  • FHIR API: https://api.platform.athenahealth.com/11721/brand/1/csg/1/fhir/r4

Ownership & related parties

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 & affiliated clinicians

Practitioners 2

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": "1406505600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1743033600000",
    "number": "1154739787",
    "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": "801-429-2000",
            "fax_number": "018-429-2001"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "133 S 500 E",
            "address_2": "SUITE 101",
            "city": "VERNAL",
            "state": "UT",
            "postal_code": "840782728",
            "telephone_number": "435-789-2024",
            "fax_number": "435-789-2034"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAINLANDS COMMUNITY HEALTH CENTER, INC.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAINLANDS COMMUNITY HEALTH CENTER",
        "enumeration_date": "2014-07-28",
        "last_updated": "2025-03-27",
        "certification_date": "2025-03-27",
        "status": "A",
        "authorized_official_last_name": "BAILEY",
        "authorized_official_first_name": "TODD",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-429-2000",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "MBA, CMPE"
    },
    "taxonomies": [
        {
            "code": "261QD0000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Dental",
            "state": "UT",
            "license": "138432-9922",
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Vernal, 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.