NPIMap

Organization Active NPI

Moab Valley Healthcare Inc

Doing business as Moab Regional Health Center

  • Certified Registered Nurse Anesthetist
  • Moab, UT
National Provider Identifier
1700857398
Registry record updated Feb 23, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Certified Registered Nurse AnesthetistTaxonomy code 367500000X
Legal business name
MOAB VALLEY HEALTHCARE INC
Doing business as
Moab Regional Health Center
Practice address
450 Williams Way
Moab, UT 84532
Phone
(435) 719-3538
Fax
(435) 719-3549
NPI assigned
Jan 31, 2006
Last updated
Feb 23, 2017By the provider in NPPES
Organization subpart
Yes
Parent organization
MOAB VALLEY HEALTHCARE INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 23, 2017

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

Authorized official

Name
Ms. Jennifer Jo Safoff
Title
Chief Executive Officer
Phone
(435) 719-3514

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Certified Registered Nurse Anesthetist 367500000X Primary
Anesthesiology Physician 207L00000X
Internal Medicine Physician 207R00000X
Orthopaedic Surgery Physician 207X00000X
Body Imaging Physician 2085B0100X
Surgery Physician 208600000X

Addresses

Primary practice location

450 Williams Way
Moab, UT 84532

Mailing address

PO Box 998
450 Williams Way
Moab, UT 84532
Phone (435) 719-3501

Other identifiers 1

IdentifierTypeStateIssuer
870391981011MedicaidUT

Other names 1

  • Moab Regional Health Center Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20040114000346 UT Part B Supplier - Clinic/Group Practice 2466361720 Receives reassigned benefits from 96 practitioners
2 other NPIs on this enrollment
This NPI is an additional NPI on the enrollment
Practice locations: Moab, UT

Other NPIs on the same Medicare enrollment 2

NPIs listed together on one Medicare enrollment, typically parts of the same organization.

National Provider Directory

National Provider Directory
Part of
Moab Valley Healthcare Inc

Locations

476 W Williams Way
Moab, UT 84532
Phone (435) 719-3500

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 29

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.

View all 29

NPI Registry JSON

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

{
    "created_epoch": "1138665600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1487808000000",
    "number": "1700857398",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 998",
            "address_2": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "84532",
            "telephone_number": "435-719-3501",
            "fax_number": "435-719-3509"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "450 WILLIAMS WAY",
            "city": "MOAB",
            "state": "UT",
            "postal_code": "84532",
            "telephone_number": "435-719-3538",
            "fax_number": "435-719-3549"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOAB VALLEY HEALTHCARE INC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOAB VALLEY HEALTHCARE INC",
        "enumeration_date": "2006-01-31",
        "last_updated": "2017-02-23",
        "status": "A",
        "authorized_official_last_name": "SAFOFF",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_middle_name": "JO",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "435-719-3514",
        "authorized_official_name_prefix": "Ms."
    },
    "taxonomies": [
        {
            "code": "367500000X",
            "taxonomy_group": "",
            "desc": "Nurse Anesthetist, Certified Registered",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "207L00000X",
            "taxonomy_group": "",
            "desc": "Anesthesiology",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207X00000X",
            "taxonomy_group": "",
            "desc": "Orthopaedic Surgery",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2085B0100X",
            "taxonomy_group": "",
            "desc": "Radiology, Body Imaging",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "208600000X",
            "taxonomy_group": "",
            "desc": "Surgery",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "870391981011",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Moab Regional Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Moab, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 23, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.