NPIMap

Organization Active NPI

Southwest Utah Community Health Center

  • Federally Qualified Health Center (FQHC)
  • Springdale, UT
National Provider Identifier
1275314528
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
SOUTHWEST UTAH COMMUNITY HEALTH CENTER
Practice address
120 Lina Blvd
Springdale, UT 84767
Phone
(435) 986-2565
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Lori Wright
Title
Ceo
Phone
(435) 986-2565

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Federally Qualified Health Center (FQHC) 261QF0400X Primary

Addresses

Primary practice location

120 Lina Blvd
Springdale, UT 84767

Mailing address

2276 E Riverside Dr
St George, UT 84790-2636

Other names 1

  • Family Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231226001244 UT Part A Provider - Federally Qualified Health Center (FQHC) 5799692398 Practice locations: Springdale, UT

Federally qualified health center certification: CCN 461000

Legal name
SOUTHWEST UTAH COMMUNITY HEALTH CENTER
Doing business as
FAMILY HEALTHCARE
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jan 18, 2024
Last certification
Jan 18, 2024
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Enrollment address
120 Lion Blvd
Springdale, UT 84767-7724

Other NPIs with the same Medicare PAC ID 3

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

National Provider Directory

National Provider Directory
Tax ID family
Family Healthcare Pharmacy9 organizations share this tax ID, including this one

Other organizations with this tax ID 8

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

Locations

2410 E Riverside Dr
St George, UT 84790
Phone (435) 986-2565

168 N 100 E
Ste 101
St George, UT 84770
Phone (435) 986-2565

Ownership & related parties

All disclosed owners & managing parties 12

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

NameRoleSinceShare
Greg B Walker Individual Corporate Director Jun 8, 2010
Richard M Isom Individual Corporate Director Dec 13, 2011
Lorraine B Wright Individual Corporate Officer Oct 27, 2014
W-2 Managing Employee Oct 27, 2014
Del Beatty Individual Corporate Director Aug 12, 2014
Sherri L Dial Individual Corporate Director Apr 8, 2014
Southwest Utah Community Health Center Organization, St George, UT Other Nov 1, 2023 100%
Rita Osborn Individual Corporate Director Oct 8, 2013
Tina Allen-Heward Individual Corporate Director Feb 23, 2015
Hopi Hunt Individual Corporate Director Sep 16, 2019
Jackelyn Jazmin Choto Individual Corporate Officer Aug 6, 2019
Travis Fullmer Individual 5% Or Greater Direct Ownership Interest Aug 20, 2018
Mary Hatch Individual Corporate Director Jul 13, 2010

Owners & managing parties with NPI records 3

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

All facility ownership & control disclosures 1

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

FacilityTypeRoleSince
Family HealthcareCedar City, UT, CCN 461846 Federally qualified health center 5% Or Greater Direct Ownership Interest (100%) Aug 1, 2015

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Practitioners & affiliated clinicians

Practitioners 31

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

View all 31

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697068800000",
    "number": "1275314528",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2276 E RIVERSIDE DR",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902636"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "120 LINA BLVD",
            "city": "SPRINGDALE",
            "state": "UT",
            "postal_code": "84767",
            "telephone_number": "435-986-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTHWEST UTAH COMMUNITY HEALTH CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "WRIGHT",
        "authorized_official_first_name": "LORI",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-986-2565"
    },
    "taxonomies": [
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Family Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Springdale, UT

Sources for this page

Verify at the official NPI Registry.