Ihc Health Services Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

IHC HEALTH SERVICES INC

Doing business as

Intermountain Health Hospice Fillmore
Intermountain Health Hospice Heber City
Intermountain Health Hospice Mt. Pleasant4 more in Other names

Practice address

11520 S Redwood Road
South Jordan, UT 84095

Phone

(385) 887-6000

Fax

(801) 442-0603

NPI assigned

Nov 22, 2006

Last updated

Jan 29, 2025By 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

Mark Provan

Title

VP-Homecare Hospice Palliative Care

Phone

(801) 442-2000

Specialties & licenses 1

Addresses

Other names 7

• Intermountain Health Hospice Fillmore Doing business as
• Intermountain Health Hospice Heber City Doing business as
• Intermountain Health Hospice Mt. Pleasant Doing business as
• Intermountain Health Hospice Ogden Doing business as
• Intermountain Health Hospice Provo Doing business as
• Intermountain Health Hospice Richfield Doing business as
• Intermountain Health Hospice Salt Lake Doing business as

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1720153711. Details of each certification follow.

• CCN 461503 Hospice · Active · Details

Hospice certification: CCN 461503

Legal name

IHC HEALTH SERVICES INC

Doing business as

INTERMOUNTAIN HEALTH HOSPICE - SALT LAKE

Certification status

Active

Provider type (POS)

Hospice

Participating since

Apr 7, 1992

Last certification

Jan 7, 2021

Ownership / control type

Non-Profit - Other

Organization structure

CorporationNon-profit

Incorporated

Sep 1, 1982 in UT

Enrollment address

11520 S Redwood Rd
South Jordan, UT 84095-7805

Listed as

Intermountain Health Hospice - Salt LakeCCN 461503 · All quality measures

Ownership

For-Profit

Certified

Apr 7, 1992

Medicare certification status

ActiveFrom the Provider of Services file

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

CLIA laboratory certificates

Tax ID family

Ut Valley Med Ctr Pharm499 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

• Ihc Health Services Inc

  dba LDS Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
  • NPI 1699795831
  NPD tax ID
• Ihc Health Services Inc

  dba Intermountain Taylorsville Pharmacy

  • Community/Retail Pharmacy
  • Taylorsville, UT
  • NPI 1699882852
  NPD tax ID
• Ihc Health Services Inc

  dba IMED Utah Heart - AVH

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1699909457
  NPD tax ID
• Ihc Health Services Inc

  dba Hurricane Valley WorkMed

  • Occupational Medicine Physician
  • Hurricane, UT
  • NPI 1700602141
  NPD tax ID
• Ihc Health Services Inc

  dba DRMC Diabetes Clinic

  • Multi-Specialty Clinic/Center
  • St George, UT
  • NPI 1710002605
  NPD tax ID
• Ihc Health Services Inc

  dba IMED Nurse Midwifery

  • Multi-Specialty Clinic/Center
  • Murray, UT
  • NPI 1710200373
  NPD tax ID
• Ihc Health Services Inc

  dba Taylorsville Specialty Clinic

  • Allergy & Immunology Physician
  • Taylorsville, UT
  • NPI 1710384367
  NPD tax ID
• Ihc Health Services Inc

  dba Park City Psychiatry and Counseling

  • Psychiatry Physician
  • Park City, UT
  • NPI 1710528724
  NPD tax ID
• Ihc Health Services Inc

  dba Intermountain Cancer Center

  • Medical Oncology Physician
  • Provo, UT
  • NPI 1710658687
  NPD tax ID
• Ihc Health Services Inc

  dba Logan Regional Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Logan, UT
  • NPI 1710996673
  NPD tax ID
• Ihc Health Services Inc

  dba Heber Valley Hospital Physicians

  • Multi-Specialty Clinic/Center
  • Heber City, UT
  • NPI 1720032865
  NPD tax ID
• Ihc Health Services Inc

  dba Utah Valley Vascular Surgery

  • Vascular Surgery Physician
  • Provo, UT
  • NPI 1720356538
  NPD tax ID

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 2

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Shannon Cooke Baker, M.D.

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1518025360

  Corporate Director

  CMS ownership
• William Thomas Caine, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Murray, UT
  • NPI 1811075278

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 44

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 11

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Wayne O Brown, MD

  • Family Medicine Physician
  • Fillmore, UT
  • NPI 1003822909

  Hospice

  Care Compare affiliation
• Elise Brinson Fazio, DO

  • Family Medicine Physician
  • Ogden, UT
  • NPI 1710366299

  Hospice

  Care Compare affiliation
• Timothy Fuller

  • Emergency Medicine Physician
  • Salt Lake City, UT
  • NPI 1770994550

  Hospice

  Care Compare affiliation
• Cort Berne Leavitt, MD

  • Hospitalist Physician
  • St George, UT
  • NPI 1326394693

  Hospice

  Care Compare affiliation
• Bentley R McEntire, M.D.

  • Hospitalist Physician
  • Ogden, UT
  • NPI 1306875489

  Hospice

  Care Compare affiliation
• Jeffrey M McNally, MD

  • Emergency Medical Services (Emergency Medicine) Physician
  • Sandy, UT
  • NPI 1093733354

  Hospice

  Care Compare affiliation
• Brett Cardon Porter, MD

  • Internal Medicine Physician
  • Tooele, UT
  • NPI 1134175037

  Hospice

  Care Compare affiliation
• Matthew Michael Schellenberg, D.O.

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Murray, UT
  • NPI 1386855021
  Care Compare affiliation
• Mark D. Sims, MD

  • Hospitalist Physician
  • Salt Lake City, UT
  • NPI 1376806745

  Hospice

  Care Compare affiliation
• Jared West, D.O.

  • Family Medicine Physician
  • Richfield, UT
  • NPI 1821418500

  Hospice

  Care Compare affiliation
• Dallin R. Olson, MD

  • Family Medicine Physician
  • Muncie, IN
  • NPI 1770964751

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1720153711",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD ROAD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD ROAD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "84095",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "PROVAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP-HOMECARE HOSPICE PALLIATIVE CARE",
        "authorized_official_telephone_number": "801-442-2000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Hospice Fillmore",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Heber City",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Mt. Pleasant",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Ogden",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Provo",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Richfield",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Intermountain Health Hospice Salt Lake",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ihc Health Services Inc (Palliative Care-Home Based)
• Ihc Health Services Inc (Intermountain Health Infusion Pharmacy Salt Lake)
• Ihc Health Services Inc (Intermountain Health Home Health Heber City)
• Ihc Health Services Inc (Post Acute Care - Clinical)
• Ihc Health Services Inc (Intermountain at Home)
• Ihc Health Services Inc (South Jordan Clinic)
• Ihc Health Services Inc
• Tochukwu Ikpeze, MD
• Rumika Imdad, DDS
• Injury Clinic, LLC

• Community Based Hospice Care Agency in South Jordan, UT
• Providers in South Jordan, UT by specialty
• Community Based Hospice Care Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.