NPIMap

Organization Active NPI

Community Health Centers, Inc.

  • Federally Qualified Health Center (FQHC)
  • Tremonton, UT
National Provider Identifier
1477979896
Registry record updated Oct 30, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Federally Qualified Health Center (FQHC)Taxonomy code 261QF0400X
Legal business name
COMMUNITY HEALTH CENTERS, INC.
Practice address
440 W 600 N
Tremonton, UT 84337-2400
Phone
(435) 723-8276
Fax
(435) 734-9761
NPI assigned
Mar 10, 2014
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 30, 2023

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

Authorized official

Name
Jennifer Lyn Thomas
Title
Executive Director
Phone
(801) 412-6920

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
DentistGroup: 193200000X MULTI-SPECIALTY GROUP 122300000X
Dental HygienistGroup: 193200000X MULTI-SPECIALTY GROUP 124Q00000X
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X
Internal Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207R00000X
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X
Federally Qualified Health Center (FQHC) 261QF0400X Primary
Multi-Specialty Clinic/Center 261QM1300X

Addresses

Primary practice location

440 W 600 N
Tremonton, UT 84337-2400

Mailing address

1455 W 2200 S Ste 300
West Valley City, UT 84119-7219
Phone (801) 412-6920

Other names 2

  • Bear River Medical Clinic Doing business as
  • Bear River Clinic Other name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20040203000767 UT Part B Supplier - Clinic/Group Practice 5991698169 Receives reassigned benefits from 66 practitioners
10 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: West Valley City, UT; Tremonton, UT; Taylorsville, UT; Salt Lake City, UT; Midvale, UT; Brigham City, UT
O20150724010763 UT Part A Provider - Federally Qualified Health Center (FQHC) 5991698169 Practice locations: Tremonton, UT

Federally qualified health center certification: CCN 461847

Legal name
COMMUNITY HEALTH CENTERS INC
Certification status
Active
Provider type (POS)
Federally qualified health center
Participating since
Jul 29, 2015
Last certification
Jul 29, 2015
Ownership / control type
For profit – corporation
Organization structure
CorporationNon-profit
Incorporated
Jul 1, 1986 in UT
Enrollment address
440 West 600 North
Tremonton, UT 84337-2400

Other NPIs with the same Medicare PAC ID 7

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

Other NPIs on the same Medicare enrollment 8

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory

Locations

4745 S 3200 W
Taylorsville, UT 84129
Phone (801) 964-6214

Ownership & related parties

All disclosed owners & managing parties 8

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

NameRoleSinceShare
Vasanthi Sekhar Individual Corporate DirectorBoard Treasurer Feb 26, 2015
Keith O Horwood Individual W-2 Managing EmployeeAssociate Medical Director Feb 10, 1997
Lilli E Decair Individual Corporate DirectorBoard Member Oct 24, 2013
Jennifer Thomas Individual Corporate DirectorExecutive Director Mar 14, 2022 0.5%
W-2 Managing EmployeeExecutive Director Mar 14, 2022 100%
Martha Lilia Mendes Individual Corporate DirectorBoard Secretary Oct 24, 2013
William Henrick Nelson Individual Corporate DirectorBoard President Dec 18, 2014
Mark R Brunson Individual Corporate DirectorBoard President Feb 26, 2015
Holly Hansen Individual Corporate DirectorBoard Member Nov 21, 2013

Owners & managing parties with NPI records 1

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

Practitioners & affiliated clinicians

Practitioners 40

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

View all 40

NPI Registry JSON

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

{
    "created_epoch": "1394409600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1698624000000",
    "number": "1477979896",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1455 W 2200 S STE 300",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841197219",
            "telephone_number": "801-412-6920",
            "fax_number": "877-497-4661"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "440 W 600 N",
            "city": "TREMONTON",
            "state": "UT",
            "postal_code": "843372400",
            "telephone_number": "435-723-8276",
            "fax_number": "435-734-9761"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "COMMUNITY HEALTH CENTERS, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2014-03-10",
        "last_updated": "2023-10-30",
        "certification_date": "2023-10-30",
        "status": "A",
        "authorized_official_last_name": "THOMAS",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "LYN",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "801-412-6920"
    },
    "taxonomies": [
        {
            "code": "122300000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dentist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "124Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Dental Hygienist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QF0400X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Federally Qualified Health Center (FQHC)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Bear River Medical Clinic",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Bear River Clinic",
            "code": "5",
            "type": "Other Name"
        },
        {
            "organization_name": "Bear River Clinic",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

Other providers in Tremonton, UT

Sources for this page

Verify at the official NPI Registry.