NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Avenues Obstetrics and Gynecology

  • Obstetrics & Gynecology Physician
  • Salt Lake City, UT
National Provider Identifier
1326200940
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Obstetrics & Gynecology PhysicianTaxonomy code 207V00000X
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Avenues Obstetrics and Gynecology
Practice address
324 E 10TH Ave Ste 200
Salt Lake City, UT 84103-2869
Phone
(801) 408-7500
NPI assigned
Jun 25, 2008
Last updated
Jan 28, 2022By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Authorized official

Name
Dr. Mark Briesacher, MD
Title
SVP Chief Phys Exec-Pres MG
Phone
(801) 442-3495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Midwife 176B00000X 5342008 UT
Obstetrics & Gynecology Physician 207V00000X Primary

Addresses

Primary practice location

324 E 10TH Ave Ste 200
Salt Lake City, UT 84103-2869

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 408-1440

Other names 1

  • Avenues Obstetrics and Gynecology Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20080610000303 UT Part B Supplier - Clinic/Group Practice 1850209420 Receives reassigned benefits from 4,146 practitioners
This NPI is an additional NPI on the enrollment

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 9

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": "1214352000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1643328000000",
    "number": "1326200940",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "801-408-1440"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 E 10TH AVE STE 200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032869",
            "telephone_number": "801-408-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-06-25",
        "last_updated": "2022-01-28",
        "certification_date": "2022-01-28",
        "status": "A",
        "authorized_official_last_name": "BRIESACHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP CHIEF PHYS EXEC-PRES MG",
        "authorized_official_telephone_number": "801-442-3495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "176B00000X",
            "taxonomy_group": "",
            "desc": "Midwife",
            "state": "UT",
            "license": "5342008",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avenues Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Avenues Obstetrics and Gynecology",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 28, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.