Active NPI
Ihc Health Services, Inc
Doing business as Memorial Clinic
- Internal Medicine Physician
- Salt Lake City, UT
National Provider Identifier
1508904947
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Internal Medicine Physician
- License
- 19960601
- Legal business name
- IHC HEALTH SERVICES, INC
- Doing business as
- Memorial Clinic
- Practice address
- 2000 S 900 E
Salt Lake City, UT 84105-3208 - Phone
- (801) 464-7500
- Fax
- (801) 464-7876
- NPI assigned
- Feb 1, 2007
- Last updated
- Jul 31, 2008
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Dr. Linda C Leckman, MD
- Title
- Vice President Chief Ex Officer
- Phone
- (801) 442-3499
Specialties & licenses 14
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 19960601 | UT | |
| Pharmacist | 183500000X | 19960601 | UT | |
| Allergy & Immunology Physician | 207K00000X | 19960601 | UT | |
| Dermatology Physician | 207N00000X | 19960601 | UT | |
| Internal Medicine Physician | 207R00000X | 19960601 | UT | Primary |
| Gastroenterology Physician | 207RG0100X | 19960601 | UT | |
| Pulmonary Disease Physician | 207RP1001X | 19960601 | UT | |
| Neurological Surgery Physician | 207T00000X | 19960601 | UT | |
| Obstetrics & Gynecology Physician | 207V00000X | 19960601 | UT | |
| Orthopaedic Surgery Physician | 207X00000X | 19960601 | UT | |
| Otolaryngology Physician | 207Y00000X | 19960601 | UT | |
| Pediatrics Physician | 208000000X | 19960601 | UT | |
| Medical Laboratory Technician | 246RM2200X | 19960601 | UT | |
| Radiography Radiologic Technologist | 2471C3402X | 19960601 | UT |
Addresses
Primary practice location
2000 S 900 E
Salt Lake City, UT 84105-3208
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 464-7500
Other names 1
- Memorial Clinic
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 2
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| O20031105000079 | UT | Part B Supplier - Clinic/Group Practice | 1850209420 |
Receives reassigned benefits from 1,923 practitioners This NPI is an additional NPI on the enrollment |
| O20080610000303 | UT | Part B Supplier - Clinic/Group Practice | 1850209420 |
Receives reassigned benefits from 4,146 practitioners This NPI is an additional NPI on the enrollment |
Laboratory certificates & supplier records
Derived by NPIMapThese CMS records do not include an NPI. They are shown because their name and street address match this provider’s.
CLIA laboratory certificates
| CLIA number | Laboratory | Certificate | Expires |
|---|---|---|---|
| 46D0523696 | Memorial Clinic | Provider-performed microscopy | Dec 20, 2027 |
| 46D2116060 | Memorial Clinic - Dermatology Mohs | Compliance | Feb 15, 2027 |
National Provider Directory
National Provider DirectoryLocations
324 Tenth Ave
Ste 189
Salt Lake City, UT 84103
Phone (801) 314-4500
Practitioners & affiliated clinicians
Practitioners 23
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.
-
- Orthopaedic Surgery Physician
- Cedar City, UT
- NPI 1629242359
-
- Clinical Psychologist
- Provo, UT
- NPI 1699912394
-
- Surgery Physician
- Salt Lake City, UT
- NPI 1275570293
-
- Internal Medicine Physician
- Salt Lake City, UT
- NPI 1083652242
-
- Psychiatric/Mental Health Nurse Practitioner
- Provo, UT
- NPI 1972986057
-
- Nurse Practitioner
- Salt Lake City, UT
- NPI 1346513181
-
- Physical Therapist
- Murray, UT
- NPI 1770665705
-
- Audiologist
- SLC, UT
- NPI 1548344492
-
- Sports Medicine (Family Medicine) Physician
- Brigham City, UT
- NPI 1053631069
-
- Physician Assistant
- St George, UT
- NPI 1477101574
-
- Obstetrics & Gynecology Physician
- Sandy, UT
- NPI 1588767081
-
- Cardiovascular Disease Physician
- Ogden, UT
- NPI 1477578557
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1217462400000",
"number": "1508904947",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 27128",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841270128",
"telephone_number": "801-464-7500",
"fax_number": "801-464-7876"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2000 S 900 E",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841053208",
"telephone_number": "801-464-7500",
"fax_number": "801-464-7876"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IHC HEALTH SERVICES, INC",
"organizational_subpart": "NO",
"enumeration_date": "2007-02-01",
"last_updated": "2008-07-31",
"status": "A",
"authorized_official_last_name": "LECKMAN",
"authorized_official_first_name": "LINDA",
"authorized_official_middle_name": "C",
"authorized_official_title_or_position": "VICE PRESIDENT CHIEF EX OFFICER",
"authorized_official_telephone_number": "801-442-3499",
"authorized_official_name_prefix": "Dr.",
"authorized_official_credential": "MD"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "183500000X",
"taxonomy_group": "",
"desc": "Pharmacist",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207K00000X",
"taxonomy_group": "",
"desc": "Allergy & Immunology",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207N00000X",
"taxonomy_group": "",
"desc": "Dermatology",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207R00000X",
"taxonomy_group": "",
"desc": "Internal Medicine",
"state": "UT",
"license": "19960601",
"primary": true
},
{
"code": "207RG0100X",
"taxonomy_group": "",
"desc": "Internal Medicine, Gastroenterology",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207RP1001X",
"taxonomy_group": "",
"desc": "Internal Medicine, Pulmonary Disease",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207T00000X",
"taxonomy_group": "",
"desc": "Neurological Surgery",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207V00000X",
"taxonomy_group": "",
"desc": "Obstetrics & Gynecology",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207X00000X",
"taxonomy_group": "",
"desc": "Orthopaedic Surgery",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "207Y00000X",
"taxonomy_group": "",
"desc": "Otolaryngology",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "208000000X",
"taxonomy_group": "",
"desc": "Pediatrics",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "246RM2200X",
"taxonomy_group": "",
"desc": "Technician, Pathology, Medical Laboratory",
"state": "UT",
"license": "19960601",
"primary": false
},
{
"code": "2471C3402X",
"taxonomy_group": "",
"desc": "Radiologic Technologist, Radiography",
"state": "UT",
"license": "19960601",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Memorial Clinic",
"code": "3",
"type": "Doing Business As"
}
]
}
Other providers in Salt Lake City, UT
- Ihc Health Services Inc. (LDSH Health & Fitness Institute)
- Ihc Health Services Inc.
- Ihc Health Services Inc. (LDSH Geriatrics)
- Ihc Health Services Inc. (LDSH CC Midvalley-SLC)
- Ihc Health Services, Inc
- Ihc Health Services, Inc
- Ihc Health Services, Inc. (Intermountain Health Primary Children's Hospital)
- Ihc Health Services, Inc. (Intermountain Health LDS Hospital)
- Ihc Health Services, Inc. (Schmidt Chest Clinic)
- Chelsea Leah Ihnat
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- 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.