Milford Memorial Hospital

Primary specialty

Skilled Nursing FacilityTaxonomy code 314000000X

Legal business name

MILFORD MEMORIAL HOSPITAL

Doing business as

Midtown Manor

Practice address

125 S 900 W
Salt Lake City, UT 84104-1125

Phone

(801) 363-6340

NPI assigned

Jun 20, 2024

Last updated

Jun 20, 2024By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Tyler Moss

Title

Cfo

Phone

(435) 438-7209

Specialties & licenses 1

Addresses

Other names 1

• Midtown Manor Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1487498978. Details of each certification follow.

• CCN 465124 Skilled nursing facility · Active · Details

Skilled nursing facility certification: CCN 465124

Legal name

MILFORD MEMORIAL HOSPITAL

Doing business as

MIDTOWN MANOR

Certification status

Active

Provider type (POS)

Nursing home – SNF/NF distinct part

Participating since

Oct 17, 1990

Last certification

Aug 30, 2023

Beds

82

Ownership / control type

County

Organization structure

GovernmentNon-profit

Incorporated

Jul 2, 1982 in UT

Enrollment address

125 S 900 W
Salt Lake City, UT 84104-1125

Nursing home name

MIDTOWN MANOR

Other NPIs with the same Medicare PAC ID 4

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

• Milford Memorial Hospital

  dba Sunshine Terrace Skilled Nursing

  • Skilled Nursing Facility
  • Logan, UT
  • NPI 1063194876

  8426955055

  Same PAC ID
• Milford Memorial Hospital

  • Critical Access Hospital
  • Milford, UT
  • NPI 1427064211

  8426955055

  Same PAC ID
• Milford Memorial Hospital

  dba Monument Healthcare Millcreek

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1699533497

  8426955055

  Same PAC ID
• Milford Memorial Hospital

  dba Monument Healthcare Bountiful

  • Skilled Nursing Facility
  • Bountiful, UT
  • NPI 1841058641

  8426955055

  Same PAC ID

Listed as

Midtown ManorCCN 465124 · All quality measures

Overall star rating

1 of 5

Health inspections

2 of 5

Staffing

1 of 5

Quality measures

4 of 5

Type

Medicare and Medicaid

Ownership

Government - County

Certified

Oct 17, 1990

Medicare certification status

ActiveFrom the Provider of Services file

Certified beds

8277.3 residents per day on average

Processed by Care Compare on Aug 1, 2026.

Tax ID family

Milford Valley Hospital6 organizations share this tax ID, including this one

Other organizations with this tax ID 5

Organizations that report the same tax identification number in the National Provider Directory.

• Milford Memorial Hospital

  dba Sunshine Terrace Skilled Nursing

  • Skilled Nursing Facility
  • Logan, UT
  • NPI 1063194876
  NPD tax ID
• Milford Memorial Hospital

  • Critical Access Hospital
  • Milford, UT
  • NPI 1427064211
  NPD tax ID
• Milford Memorial Hospital

  dba Monument Healthcare Millcreek

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1699533497
  NPD tax ID
• Milford Memorial Hospital

  dba Monument Healthcare Bountiful

  • Skilled Nursing Facility
  • Bountiful, UT
  • NPI 1841058641
  NPD tax ID
• Sunshine Terrace Foundation, Inc

  • Skilled Nursing Facility
  • Logan, UT
  • NPI 1609879493
  NPD tax ID

All disclosed owners & managing parties 4

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

Owners & managing parties with NPI records 1

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

• David H Workman IX, MD

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1659329449

  Adp of the SNF, Operational/Managerial Control

  CMS ownership

All facility ownership & control disclosures 2

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

Owned or controlled facilities with NPI records 2

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

• Milford Memorial Hospital

  dba Sunshine Terrace Skilled Nursing

  • Skilled Nursing Facility
  • Logan, UT
  • NPI 1063194876

  5% Or Greater Direct Ownership Interest

  CMS ownership
• Milford Memorial Hospital

  dba Monument Healthcare Bountiful

  • Skilled Nursing Facility
  • Bountiful, UT
  • NPI 1841058641

  5% Or Greater Direct Ownership Interest, Adp of the SNF, Direct Ownership Interest, Operational/Managerial Control

  CMS ownership

Affiliated clinicians 1

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

• David H Workman IX, MD

  • Family Medicine Physician
  • Riverton, UT
  • NPI 1659329449

  Nursing home

  Care Compare affiliation

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

{
    "created_epoch": "1718841600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1718841600000",
    "number": "1487498978",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 640",
            "city": "MILFORD",
            "state": "UT",
            "postal_code": "847510640",
            "telephone_number": "435-387-2411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "125 S 900 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841041125",
            "telephone_number": "801-363-6340"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MILFORD MEMORIAL HOSPITAL",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-06-20",
        "last_updated": "2024-06-20",
        "certification_date": "2024-06-20",
        "status": "A",
        "authorized_official_last_name": "MOSS",
        "authorized_official_first_name": "TYLER",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "435-438-7209"
    },
    "taxonomies": [
        {
            "code": "314000000X",
            "taxonomy_group": "",
            "desc": "Skilled Nursing Facility",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midtown Manor",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Rodney Royce Miles, M.D., PH.D
• Sarah Alyce Miles, CMHC
• Todd Miles, D.D.S
• Milestones Integrative Healing
• Dani Miletic
• Milford Memorial Hospital (Monument Healthcare Millcreek)
• Monique G Milius, LMT
• Devan Millard, M.D.
• Millbrook Dental Management LLC (Millbrook Dental)
• Millcreek Anesthesia PC

• Skilled Nursing Facility in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Skilled Nursing Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 20, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.