NPIMap

Organization Active NPI

Confederated Tribes of the Goshute Indian Reservation

Doing business as Goshute Health Clinic

  • Non-emergency Medical Transport (VAN)
  • Ibapah, UT
National Provider Identifier
1508296310
Registry record updated Dec 19, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Non-emergency Medical Transport (VAN)Taxonomy code 343900000X
Legal business name
CONFEDERATED TRIBES OF THE GOSHUTE INDIAN RESERVATION
Doing business as
Goshute Health Clinic
Practice address
195 Tribal Center Rd
Ibapah, UT 84034
Phone
(435) 234-1138
Fax
(435) 234-1202
NPI assigned
Nov 14, 2013
Last updated
Dec 19, 2024By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 19, 2024

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

Authorized official

Name
Ms. Christine Steele
Title
Acting Health Director
Phone
(435) 234-1138

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Non-emergency Medical Transport (VAN) 343900000X Primary

Addresses

Primary practice location

195 Tribal Center Rd
Ibapah, UT 84034

Mailing address

P.O. Box 6104
195 Tribal Center Rd
Ibapah, UT 84034-6104
Phone (435) 234-1138

Other identifiers 1

IdentifierTypeStateIssuer
1750510277MedicaidUT

Other names 1

  • Goshute Health Clinic Doing business as

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
46D2156486Goshute Health Clinic195 Tribal Center Road, Ibapah, UT 84034Certificate of waiverOct 17, 2026

National Provider Directory

National Provider Directory
Tax ID family
Sacred Circle Healthcare14 organizations share this tax ID, including this one

Other organizations with this tax ID 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1384387200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1734566400000",
    "number": "1508296310",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "P.O. BOX 6104",
            "address_2": "195 TRIBAL CENTER RD",
            "city": "IBAPAH",
            "state": "UT",
            "postal_code": "840346104",
            "telephone_number": "435-234-1138",
            "fax_number": "435-234-1202"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "195 TRIBAL CENTER RD",
            "city": "IBAPAH",
            "state": "UT",
            "postal_code": "84034",
            "telephone_number": "435-234-1138",
            "fax_number": "435-234-1202"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CONFEDERATED TRIBES OF THE GOSHUTE INDIAN RESERVATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-14",
        "last_updated": "2024-12-19",
        "certification_date": "2024-12-19",
        "status": "A",
        "authorized_official_last_name": "STEELE",
        "authorized_official_first_name": "CHRISTINE",
        "authorized_official_title_or_position": "ACTING HEALTH DIRECTOR",
        "authorized_official_telephone_number": "435-234-1138",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "343900000X",
            "taxonomy_group": "",
            "desc": "Non-emergency Medical Transport (VAN)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1750510277",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Goshute Health Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Ibapah, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 19, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • 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.