Ihc Health Services Inc
Organization Active NPI Multi-Specialty Clinic/Center · Mt Pleasant, UT
NPI 1679510218 · NPPES record last updated Nov 16, 2022
Key facts
- NPI
- 1679510218
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Multi-Specialty Clinic/Center 261QM1300X
- License
- 2004HOSP204 (UT)
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 1100 S Medical Dr
Mt Pleasant, UT 84647-2222 - Phone
- (435) 462-2441
- Fax
- (435) 462-2609
- NPI assigned
- Jun 1, 2006
- Organization subpart
- No
Authorized official
- Name
- Mr. Denis Smith
- Title
- Cfo
- Phone
- (801) 442-2000
Practitioners 57
-
Brent J Allen, MD
-
Shane Arthur Baker, M.D.
-
Spencer Barfuss, MD
-
Cody McEwen Christensen, D.O.
-
Jared Colton Cox, D.O.
-
Spencer Christian Debry, M.D.
-
Kadie Dawn Egbert-Brown, PA-C
-
G Richard Ellis, PA-C
-
Sara Fausett, RDN
-
Amy Faust, AUD
-
Wayne R Graham, D.O.
-
Gary Vaughan Halversen, M.D.
-
Tiffany Sang-Mee Han, M.D.
-
Kimberly Dawn Haycock, PA-C
-
Aimee O Hersh, M.D.
-
Michael Kyle Jensen, M.D.
-
Ralph E Jensen, M.D.
-
Kristian Kemp, MD
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled (2 enrollments) in UT
Medicare enrollment records
| 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 |
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Diabetes Educator Registered Nurse |
163WD0400X | 2004HOSP204 | UT | |
| Multi-Specialty Clinic/Center | 261QM1300X | 2004HOSP204 | UT | Yes |
Addresses
Primary practice location
1100 S Medical Dr
Mt Pleasant, UT 84647-2222
Mailing address
PO Box 30180
Salt Lake City, UT 84130-0180
Other names
- Sanpete Valley Hospital Physicians
NPI Registry JSON
{
"created_epoch": "1149120000000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1668556800000",
"number": "1679510218",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 30180",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841300180"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1100 S MEDICAL DR",
"city": "MT PLEASANT",
"state": "UT",
"postal_code": "846472222",
"telephone_number": "435-462-2441",
"fax_number": "435-462-2609"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "IHC HEALTH SERVICES INC",
"organizational_subpart": "NO",
"enumeration_date": "2006-06-01",
"last_updated": "2022-11-16",
"certification_date": "2022-11-16",
"status": "A",
"authorized_official_last_name": "SMITH",
"authorized_official_first_name": "DENIS",
"authorized_official_title_or_position": "CFO",
"authorized_official_telephone_number": "801-442-2000",
"authorized_official_name_prefix": "Mr."
},
"taxonomies": [
{
"code": "163WD0400X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Registered Nurse, Diabetes Educator",
"state": "UT",
"license": "2004HOSP204",
"primary": false
},
{
"code": "261QM1300X",
"taxonomy_group": "",
"desc": "Clinic/Center, Multi-Specialty",
"state": "UT",
"license": "2004HOSP204",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"organization_name": "Sanpete Valley Hospital Physicians",
"code": "3",
"type": "Doing Business As"
}
]
}Other providers in Mt Pleasant, UT
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All providers in Mt Pleasant, UT · Multi-Specialty Clinic/Center in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Nov 16, 2022. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.