NPIMap

Organization Active NPI

Enoch Community Healthcare

  • Family Medicine Physician
  • Enoch, UT
National Provider Identifier
1659945343
Registry record updated Oct 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
ENOCH COMMUNITY HEALTHCARE
Practice address
476 E Midvalley Rd
Enoch, UT 84721-7603
Phone
(435) 263-0355
Fax
(435) 263-0123
NPI assigned
May 17, 2021
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 6, 2022

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

Authorized official

Name
Ashley Starr
Title
Office Manager / Coo
Phone
(435) 263-0355

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X Primary
Physician AssistantGroup: 193200000X MULTI-SPECIALTY GROUP 363A00000X

Addresses

Primary practice location

476 E Midvalley Rd
Enoch, UT 84721-7603

Mailing address

376 East Midvalley Road
Enoch, UT 84721
Phone (435) 263-0355

Other identifiers 1

IdentifierTypeStateIssuer
1225432669MedicaidUT

Other names 1

  • Enoch Healthcare Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20210825002410 UT Part B Supplier - Clinic/Group Practice 9739584053 Receives reassigned benefits from 7 practitioners
Practice locations: Enoch, UT

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
46D2260573Enoch Healthcare476 E Midvalley Rd, Enoch, UT 84721Certificate of waiverMay 19, 2028

National Provider Directory

National Provider Directory

Locations

476 E Midvalley Rd
Ste 2
Enoch, UT 84721
Phone (435) 263-0355

Practitioners & affiliated clinicians

Practitioners 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1621209600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1665014400000",
    "number": "1659945343",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "376 EAST MIDVALLEY ROAD",
            "city": "ENOCH",
            "state": "UT",
            "postal_code": "84721",
            "telephone_number": "435-263-0355",
            "fax_number": "435-263-0123"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "476 E MIDVALLEY RD",
            "city": "ENOCH",
            "state": "UT",
            "postal_code": "847217603",
            "telephone_number": "435-263-0355",
            "fax_number": "435-263-0123"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ENOCH COMMUNITY HEALTHCARE",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-17",
        "last_updated": "2022-10-06",
        "certification_date": "2022-10-03",
        "status": "A",
        "authorized_official_last_name": "STARR",
        "authorized_official_first_name": "ASHLEY",
        "authorized_official_title_or_position": "OFFICE MANAGER / COO",
        "authorized_official_telephone_number": "435-263-0355"
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physician Assistant",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1225432669",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Enoch Healthcare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Enoch, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 6, 2022; 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.

Verify at the official NPI Registry.