NPIMap

Organization Active NPI

Hunter Medical Center, Inc

Doing business as Jordan Meadows Medical Center.

  • Family Medicine Physician
  • West Jordan, UT
National Provider Identifier
1205957131
Registry record updated Dec 23, 2010
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
184916-1205 Issued in UT
Legal business name
HUNTER MEDICAL CENTER, INC
Doing business as
Jordan Meadows Medical Center.
Practice address
3354 W 7800 S
West Jordan, UT 84088-4506
Phone
(801) 282-2677
Fax
(801) 282-2050
NPI assigned
Apr 2, 2007
Last updated
Dec 23, 2010By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 23, 2010

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

Authorized official

Name
Dr. Frederic M Civish, M.D.NPI 1124137278
Title
Owner
Phone
(801) 282-2677

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 184916-1205 UT Primary

Addresses

Primary practice location

3354 W 7800 S
West Jordan, UT 84088-4506

Mailing address

3354 W 7800 S
West Jordan, UT 84088-4506
Phone (801) 282-2677

Other names 1

  • JORDAN MEADOWS MEDICAL CENTER. Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040308001440 UT Part B Supplier - Clinic/Group Practice 3678461951 Receives reassigned benefits from 12 practitioners
1 other NPI on this enrollment
Practice locations: West Jordan, UT; West Valley, UT

Other NPIs on the same Medicare enrollment 1

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

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
46D0934060Jordan Meadows Medical Center3354 W 7800 S, West Jordan, UT 84088Certificate of waiverJan 11, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 19

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.

View all 19

NPI Registry JSON

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

{
    "created_epoch": "1175472000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1293062400000",
    "number": "1205957131",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3354 W 7800 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884506",
            "telephone_number": "801-282-2677",
            "fax_number": "801-282-2050"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3354 W 7800 S",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840884506",
            "telephone_number": "801-282-2677",
            "fax_number": "801-282-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HUNTER MEDICAL CENTER, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-02",
        "last_updated": "2010-12-23",
        "status": "A",
        "authorized_official_last_name": "CIVISH",
        "authorized_official_first_name": "FREDERIC",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-282-2677",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "184916-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "JORDAN MEADOWS MEDICAL CENTER.",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in West Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 23, 2010; 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.