NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Intermountain Health Home Health Heber City

  • Home Health Agency
  • South Jordan, UT
National Provider Identifier
1447344098
Registry record updated Jan 29, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Home Health AgencyTaxonomy code 251E00000X
License
HHA-136 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Intermountain Health Home Health Heber City
Intermountain Health Home Health Provo
Intermountain Health Home Health Salt Lake
Practice address
11520 S Redwood Road
South Jordan, UT 84095
Phone
(385) 887-6000
Fax
(801) 442-0603
NPI assigned
Oct 3, 2006
Last updated
Jan 29, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 29, 2025

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

Authorized official

Name
Mark Provan
Title
VP-Homecare Hospice Palliative Care
Phone
(801) 442-2000

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Home Health Agency 251E00000X HHA-136 UT Primary

Addresses

Primary practice location

11520 S Redwood Road
South Jordan, UT 84095

Mailing address

11520 S Redwood Road
South Jordan, UT 84095
Phone (385) 887-6000

Other identifiers 1

IdentifierTypeStateIssuer
1447344098MedicaidUT

Other names 3

  • Intermountain Health Home Health Heber City Doing business as
  • Intermountain Health Home Health Provo Doing business as
  • Intermountain Health Home Health Salt Lake Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050418001176 UT Part A Provider - Home Health Agency 1850209420 Practice locations: South Jordan, UT; Provo, UT; Heber City, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1447344098. Details of each certification follow.

Home health agency certification: CCN 467030

Legal name
IHC HEALTH SERVICES INC
Doing business as
INTERMOUNTAIN HEALTH HOME HEALTH - SALT LAKE
Certification status
Active
Provider type (POS)
Home health agency
Participating since
Apr 23, 1984
Last certification
Aug 14, 2019
Ownership / control type
Proprietary
Organization structure
CorporationNon-profit
Incorporated
Jul 5, 1995 in UT
Enrollment address
11520 S Redwood Rd
South Jordan, UT 84095-7805
HHA Branch

Care Compare: Home health agency

Medicare Care Compare
Listed as
Intermountain Homecare Home Health Salt LakeCCN 467030 · All quality measures
Overall star rating
4 of 5
Ownership
Proprietary
Certified
Apr 23, 1984
Medicare certification status
ActiveFrom the Provider of Services file
Services
Nursing, Medical social, Home health aide, Physical therapy, Speech pathology, Occupational therapy

National Provider Directory

National Provider Directory
Tax ID family
Robert E Fowles MD485 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

Ownership & related parties

All disclosed owners & managing parties 14

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

NameRoleSinceShare
Shannon Cooke Baker Individual Corporate DirectorTrustee Jun 1, 2024
Robert Pettitt Individual Corporate DirectorTrustee Jun 7, 2023
Elizabeth Owens Individual Corporate DirectorTrustee Jun 1, 2024
William Caine Individual Corporate DirectorTrustee Jun 7, 2023
Patricia Ricks Individual Corporate DirectorTrustee Jun 1, 2024
Susan Robel Individual Corporate DirectorTrustee Apr 1, 2022
Deirdra Walsh Individual Corporate DirectorTrustee Jun 7, 2023
Robert Spendlove Individual Corporate DirectorTrustee Jun 1, 2024
Matt C Packard Individual Corporate DirectorBoard Member Jul 27, 2016
Riley Watts Individual Corporate OfficerFinance Director Sep 16, 2024
W-2 Managing EmployeeFinance Director Sep 16, 2024
Mark Provan Individual Corporate OfficerVP Homecare, Hospice, Palliative Nov 13, 2023
Patricia K Ravert Individual Corporate DirectorBoard Member Oct 8, 2017 100%
William Hulterstrom Individual Corporate DirectorTrustee Jun 7, 2023
Robert W Allen Individual Corporate DirectorCeo Dec 1, 2022

Owners & managing parties with NPI records 2

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

All facility ownership & control disclosures 44

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

FacilityTypeRoleSince
Intermountain Health Cedar City HospitalCedar City, UT, CCN 460007 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1981
Mountain View HospitalIdaho Falls, ID, CCN 130065 Hospital 5% Or Greater Direct Ownership Interest (15%) Mar 31, 2023
Intermountain Health St George Regional HospitalSt George, UT, CCN 460021 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health McKay-Dee HospitalOgden, UT, CCN 460004 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1976
Jan 1, 1976
Intermountain Health Sevier Valley HospitalRichfield, UT, CCN 460026 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Intermountain Health Bear River Valley HospitalTremonton, UT, CCN 460039 Hospital 5% Or Greater Direct Ownership Interest Jul 5, 1995
Intermountain Health Logan Regional HospitalLogan, UT, CCN 460015 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Intermountain Medical CenterMurray, UT, CCN 460010 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Alta View HospitalSandy, UT, CCN 460044 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 7, 1982
Intermountain Health American Fork HospitalAmerican Fork, UT, CCN 460023 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health LDS HospitalSalt Lake City, UT, CCN 460006 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Orem Community HospitalOrem, UT, CCN 460043 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Primary Children's HospitalSalt Lake City, UT, CCN 463301 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 1, 1980
Intermountain Health Utah Valley HospitalProvo, UT, CCN 460001 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Sanpete Valley HospitalMount Pleasant, UT, CCN 461303 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Cassia Regional HospitalBurley, ID, CCN 131326 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Delta Community HospitalDelta, UT, CCN 461300 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Intermountain Health Fillmore Community HospitalFillmore, UT, CCN 461301 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Heber Valley HospitalHeber City, UT, CCN 461307 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Delta Community HospitalDelta, UT, CCN 46Z300 Hospital 5% Or Greater Direct Ownership Interest (100%) Dec 29, 2008
Intermountain Health Fillmore Community HospitalFillmore, UT, CCN 46Z301 Hospital 5% Or Greater Direct Ownership Interest (100%) Sep 9, 2008
Heber Valley HospitalHeber City, UT, CCN 46Z307 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Apr 1, 1975
Apr 1, 1975
Intermountain Medical Center-RehabilitationMurray, UT, CCN 46T010 Hospital 5% Or Greater Direct Ownership Interest (100%) Aug 7, 2007
Ihc Health Services IncSt George, UT, CCN 46T021 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Apr 1, 1975
Jan 1, 1976
McKay Dee HospitalOgden, UT, CCN 46T004 Hospital 5% Or Greater Direct Ownership Interest
Operational/Managerial Control		 Jan 1, 1976
Jan 1, 1976
Intermountain Health St George Regional HospitalProvo, UT, CCN 46T001 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Sanpete Valley HospitalMt Pleasant, UT, CCN 46Z303 Hospital 5% Or Greater Direct Ownership Interest (100%)
Operational/Managerial Control		 Apr 1, 1975
Apr 1, 1975
Intermountain Health Park City HospitalPark City, UT, CCN 460057 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Intermountain Health Riverton HospitalRiverton, UT, CCN 460058 Hospital 5% Or Greater Direct Ownership Interest (100%) Nov 2, 2009
Intermountain Health Garfield Memorial HospitalPanguitch, UT, CCN 461333 Hospital Operational/Managerial Control Jan 1, 2017
Intermountain Health Garfield Memorial HospitalPanguitch, UT, CCN 46Z333 Hospital Operational/Managerial Control Jul 1, 2000
Intermountain Health Layton HospitalLayton, UT, CCN 460061 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Idaho Falls Community Hospital LLCIdaho Falls, ID, CCN 130074 Hospital 5% Or Greater Direct Ownership Interest (20%) Mar 31, 2023
Intermountain Health Spanish Fork HospitalSpanish Fork, UT, CCN 460062 Hospital 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1970
Cassia Regional HospitalBurley, ID, CCN 13Z326 Hospital 5% Or Greater Direct Ownership Interest (100%) Apr 1, 1975
Logan Regional Hospital Transitional Care UnitLogan, UT, CCN 465123 Skilled nursing facility Operational/Managerial Control Jul 29, 2008
Intermountain Health Home Health - Mt. PleasantMount Pleasant, UT, CCN 467016 Home health agency 5% Or Greater Direct Ownership Interest (100%) Aug 1, 1980
Intermountain Health Home Health - OgdenOgden, UT, CCN 467004 Home health agency 5% Or Greater Direct Ownership Interest (100%) Jan 1, 1976
Intermountain Health Home Health - St. GeorgeSt George, UT, CCN 467033 Home health agency 5% Or Greater Direct Ownership Interest (100%) Mar 25, 2009
Intermountain Health Hospice - LoganLogan, UT, CCN 461504 Hospice 5% Or Greater Direct Ownership Interest (100%) Oct 1, 2009
Garfield Memorial HospitalPanguitch, UT, CCN 463984 Rural health clinic Operational/Managerial Control Jan 21, 2010
Garfield CountyCircleville, UT, CCN 463980 Rural health clinic Operational/Managerial Control Apr 26, 2010
Bryce Valley ClinicCannonville, UT, CCN 463981 Rural health clinic Operational/Managerial Control Apr 26, 2010
Upper Valley FamilymedicineRigby, ID, CCN 138538 Rural health clinic 5% Or Greater Direct Ownership Interest Apr 7, 2025

Practitioners & affiliated clinicians

Affiliated clinicians 168

Clinicians who list this facility as an affiliation in Medicare Care Compare.

View all 168

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1447344098",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD ROAD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD ROAD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-10-03",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "PROVAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP-HOMECARE HOSPICE PALLIATIVE CARE",
        "authorized_official_telephone_number": "801-442-2000"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "HHA-136",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1447344098",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Home Health Heber City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Home Health Provo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Home Health Salt Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

Verify at the official NPI Registry.