NPIMap

Organization Active NPI

Four Corners Community Behavioral Health, Inc.

  • Community/Behavioral Health Agency
  • Price, UT
National Provider Identifier
1487715330
Registry record updated Aug 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
11967 Issued in UT
Legal business name
FOUR CORNERS COMMUNITY BEHAVIORAL HEALTH, INC.
Practice address
690 E Main St
Price, UT 84501-3166
Phone
(435) 637-7200
Fax
(435) 637-2377
NPI assigned
Dec 13, 2006
Last updated
Aug 19, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 19, 2021

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

Authorized official

Name
Melissa Huntington, CMHCNPI 1821113317
Title
Executive Director
Phone
(435) 613-2179

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 11967 UT Primary

Addresses

Primary practice location

690 E Main St
Price, UT 84501-3166

Mailing address

PO Box 867
Price, UT 84501-0867
Phone (435) 637-7200

Electronic endpoints 1

TypeEndpointUseAffiliation
CONNECT URL Credible Health Information Exchange (HIE)

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040220000304 UT Part B Supplier - Clinic/Group Practice 2769377415 Receives reassigned benefits from 35 practitioners
Practice locations: Castle Dale, UT; Moab, UT; Price, UT

Other NPIs with the same Medicare PAC ID 1

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

National Provider Directory

National Provider Directory

Locations

198 E Center St
Moab, UT 84532
Phone (435) 259-2432

105 W 100 N
Price, UT 84501

Practitioners & affiliated clinicians

Practitioners 216

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.

View all 216

NPI Registry JSON

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

{
    "created_epoch": "1165968000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629331200000",
    "number": "1487715330",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 867",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845010867",
            "telephone_number": "435-637-7200",
            "fax_number": "435-637-2377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "690 E MAIN ST",
            "city": "PRICE",
            "state": "UT",
            "postal_code": "845013166",
            "telephone_number": "435-637-7200",
            "fax_number": "435-637-2377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOUR CORNERS COMMUNITY BEHAVIORAL HEALTH, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-12-13",
        "last_updated": "2021-08-19",
        "certification_date": "2021-08-19",
        "status": "A",
        "authorized_official_last_name": "HUNTINGTON",
        "authorized_official_first_name": "MELISSA",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "435-613-2179",
        "authorized_official_credential": "CMHC"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "UT",
            "license": "11967",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "Credible",
            "affiliation": "N",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "address_1": "690 E Main St",
            "city": "Price",
            "state": "UT",
            "country_code": "US",
            "postal_code": "845013166",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Price, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 19, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.