NPIMap

Organization Active NPI

Catholic Health Initiatives Colorado

Doing business as Imwj Int Med W Jor

  • Internal Medicine Physician
  • West Jordan, UT
National Provider Identifier
1396447645
Registry record updated Feb 17, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Internal Medicine PhysicianTaxonomy code 207R00000X
Legal business name
CATHOLIC HEALTH INITIATIVES COLORADO
Doing business as
Imwj Int Med W Jor
Practice address
3570 W 9000 S Ste 100
West Jordan, UT 84088-8871
Phone
(801) 903-5620
Fax
(801) 569-2384
NPI assigned
Mar 20, 2023
Last updated
Feb 17, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 17, 2025

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

Authorized official

Name
Mrs. Angela J Skinner
Title
Administrator, Oma
Phone
(303) 673-7175

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Internal Medicine Physician 207R00000X NU Primary

Addresses

Primary practice location

3570 W 9000 S Ste 100
West Jordan, UT 84088-8871

Mailing address

PO Box 800022
Kansas City, MO 64180-0022
Phone (800) 953-0104

Other names 3

  • IMWJ INT MED W JOR Doing business as
  • Internal Medicine West Jordan Other name
  • Primary Care Jordan Valley Other name

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230615001995 UT Part B Supplier - Clinic/Group Practice 8022927342 Receives reassigned benefits from 168 practitioners
This NPI is an additional NPI on the enrollment
Practice locations: South Jordan, UT; West Jordan, UT; West Valley, UT; West Valley City, UT; Eagle Mountain, UT; Salt Lake City, UT; Cottonwood Heights, UT; Kaysville, UT…

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
46D0523185Commonspirit Primary Care Jordan Valley3570 W 9000 S Ste 100, West Jordan, UT 84088Certificate of waiverApr 30, 2027

National Provider Directory

National Provider Directory
Tax ID family
St Mary-Corwin Hospital319 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

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": "1679270400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739750400000",
    "number": "1396447645",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 800022",
            "city": "KANSAS CITY",
            "state": "MO",
            "postal_code": "641800022",
            "telephone_number": "800-953-0104",
            "fax_number": "303-765-6670"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3570 W 9000 S STE 100",
            "city": "WEST JORDAN",
            "state": "UT",
            "postal_code": "840888871",
            "telephone_number": "801-903-5620",
            "fax_number": "801-569-2384"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CATHOLIC HEALTH INITIATIVES COLORADO",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-03-20",
        "last_updated": "2025-02-17",
        "certification_date": "2025-02-17",
        "status": "A",
        "authorized_official_last_name": "SKINNER",
        "authorized_official_first_name": "ANGELA",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "ADMINISTRATOR, OMA",
        "authorized_official_telephone_number": "303-673-7175",
        "authorized_official_name_prefix": "Mrs."
    },
    "taxonomies": [
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "IMWJ INT MED W JOR",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Internal Medicine West Jordan",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Primary Care Jordan Valley",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

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 Feb 17, 2025; 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.