Ihc Health Services Inc

Primary specialty

Internal Medicine PhysicianTaxonomy code 207R00000X

License

20040897 Issued in UT

Legal business name

IHC HEALTH SERVICES INC

Doing business as

Avenues Specialty Clinic

Practice address

324 10TH Ave
#200
Salt Lake City, UT 84103-2853

Phone

(801) 408-7500

NPI assigned

Feb 21, 2007

Last updated

Sep 3, 2010By the provider in NPPES

Organization subpart

No

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

Ceo Intermountain Medical Group

Phone

(801) 442-3974

Specialties & licenses 7

Addresses

Other names 1

• Avenues Specialty Clinic Doing business as

Medicare fee-for-service enrollment

Enrolled in UT2 enrollments

Enrollment records 2

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

Practitioners 10

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.

• Nancy Meiyun-Chiu Bivens, M.D., PH.D.

  • Psychiatry Physician
  • Kaysville, UT
  • NPI 1760503072
  NPD
• Matthew Thomas Bryan, M.D.

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1720349814

  Internal Medicine

  NPD
• Grant E Child, CMHC

  • Mental Health Counselor
  • Layton, UT
  • NPI 1144422007
  NPD
• Shae Francom, FNP

  • Nurse Practitioner
  • Layton, UT
  • NPI 1013412063
  NPD
• Jennifer Lynne Merkley, APRN

  • Acute Care Nurse Practitioner
  • SLC, UT
  • NPI 1245683127

  Geriatric Medicine

  NPD
• Andy Nguyen

  • Internal Medicine Physician
  • Salt Lake City, UT
  • NPI 1033362694
  NPD
• Whitney Stryker, RN

  • Nurse Practitioner
  • Salt Lake City, UT
  • NPI 1518541184
  NPD
• Brad Tanner, PA

  • Vascular Surgery Physician
  • Murray, UT
  • NPI 1831407147
  NPD
• Liron Gokovski, MD

  • Hospitalist Physician
  • Rock Springs, WY
  • NPI 1730709130
  NPD
• Patrice Ferron Hirning, M.D.

  • Internal Medicine Physician
  • Nampa, ID
  • NPI 1770580078
  NPD

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1283472000000",
    "number": "1689709859",
    "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": "801-408-7500"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "324 10TH AVE",
            "address_2": "#200",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032853",
            "telephone_number": "801-408-7500"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2010-09-03",
        "status": "A",
        "authorized_official_last_name": "LECKMAN",
        "authorized_official_first_name": "LINDA",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "CEO INTERMOUNTAIN MEDICAL GROUP",
        "authorized_official_telephone_number": "801-442-3974",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "163WW0101X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Women's Health Care, Ambulatory",
            "state": "UT",
            "license": "6312010",
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": "UT",
            "license": "20040897",
            "primary": true
        },
        {
            "code": "207RG0100X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Gastroenterology",
            "state": "UT",
            "license": "6312010",
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "UT",
            "license": "20040897",
            "primary": false
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "6312010",
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": "UT",
            "license": "6312010",
            "primary": false
        },
        {
            "code": "208800000X",
            "taxonomy_group": "",
            "desc": "Urology",
            "state": "UT",
            "license": "6312010",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Avenues Specialty Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ihc Health Services Inc (Salt Lake Clinic)
• Ihc Health Services Inc (Liberty Elementary)
• Ihc Health Services Inc (Intermountain Avenues Women's Center)
• Ihc Health Services Inc (Blood and Marrow Transplant/Leukemia Program)
• Ihc Health Services Inc
• Ihc Health Services Inc (LDS Hospital Physicians)
• Ihc Health Services Inc (Intermountain Surgical Oncology)
• Ihc Health Services Inc (Memorial Radiology)
• Ihc Health Services Inc (Primary Childrens Outpatient Pharmacy)
• Ihc Health Services Inc (PCH Eeg)

• Internal Medicine Physician in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Internal Medicine Physician in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2010; 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.