Ihc Health Services Inc
Organization Active NPI Surgical Oncology Physician · Salt Lake City, UT
NPI 1750417853 · NPPES record last updated Jan 7, 2014
Key facts
- NPI
- 1750417853
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Surgical Oncology Physician 2086X0206X
- License
- 20012306 (UT)
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 5169 Cottonwood St
Ste 440
Salt Lake City, UT 84107-6774 - Phone
- (801) 507-3915
- NPI assigned
- Feb 26, 2007
- Organization subpart
- No
Authorized official
- Name
- Dr. Linda C Leckman, MD
- Title
- Ceo Intermountain Medical Group
- Phone
- (801) 442-3974
Practitioners 8
-
Benjamin Erik Bradford, APRN
-
Taylor Jay Christensen, M.D.
-
Valeria Dias, MD
-
Kelli Elaine Groomer, P.A.
-
Imran M. Raja, M.D.
-
Nikhil Sripathi Karanth, M.D.
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 |
|---|---|---|---|---|
| Surgical Oncology Physician |
2086X0206X | 20012306 | UT | Yes |
Addresses
Primary practice location
5169 Cottonwood St
Ste 440
Salt Lake City, UT 84107-6774
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 408-3555
Other names
- Intermountain Surgical Oncology
Other providers in Salt Lake City, UT
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
- Ihc Health Services Inc
All providers in Salt Lake City, UT · Surgical Oncology Physician in Utah
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 7, 2014. 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.