NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Intermountain Provo InstaCare

  • Urgent Care Clinic/Center
  • Provo, UT
National Provider Identifier
1396982203
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Urgent Care Clinic/CenterTaxonomy code 261QU0200X
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Intermountain Provo InstaCare
Utah Valley InstaCare
Practice address
395 W Cougar Blvd Ste 205
Provo, UT 84604-3328
Phone
(801) 357-1770
NPI assigned
Jan 14, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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 Img
Phone
(801) 442-3495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Emergency Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207P00000X 8602008 UT
Urgent Care Clinic/Center 261QU0200X Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 205
Provo, UT 84604-3328

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 357-1770

Other practice location 1

1134 N 500 W
#103
Provo, UT 84604-3383
Phone (801) 357-1770

Other names 2

  • Intermountain Provo InstaCare Doing business as
  • Utah Valley InstaCare 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

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
46D1096646Utah Valley Clinic - Instacare395 West Cougar Blvd Suite 205, Provo, UT 84604RegistrationJan 14, 2027

National Provider Directory

National Provider Directory

Locations

9493 S 700 E
Sandy, UT 84070
Phone (801) 270-4400

Practitioners & affiliated clinicians

Practitioners 12

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": "1231891200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1396982203",
    "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": "801-357-1770"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 205",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043328",
            "telephone_number": "801-357-1770"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1134 N 500 W",
            "address_2": "#103",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "846043383",
            "country_code": "US",
            "telephone_number": "801-357-1770",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-14",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "BRIESACHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP-CHIEF PHYS EXEC / PRES IMG",
        "authorized_official_telephone_number": "801-442-3495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207P00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Emergency Medicine",
            "state": "UT",
            "license": "8602008",
            "primary": false
        },
        {
            "code": "261QU0200X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Urgent Care",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Provo InstaCare",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Utah Valley InstaCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.