NPIMap

Organization Active NPI

Ihc Health Services Inc

  • Family Medicine Physician
  • South Jordan, UT
National Provider Identifier
1811032048
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3350 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Practice address
11444 S Redwood Rd
South Jordan, UT 84095-7803
Phone
(801) 253-5900
NPI assigned
Feb 21, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 2008

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 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193400000X SINGLE SPECIALTY GROUP 207Q00000X 3350 UT Primary

Addresses

Primary practice location

11444 S Redwood Rd
South Jordan, UT 84095-7803

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 253-5900

Other names 1

  • South Jordan Clinic Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
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

Laboratory certificates & supplier records

Derived by NPIMap

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

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D0723939Intermountain South Jordan Clinic11444 S Redwood Rd, South Jordan, UT 84095Certificate of waiverMar 15, 2027

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 16

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 16

NPI Registry JSON

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

{
    "created_epoch": "1172016000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1811032048",
    "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": "801-253-5900"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11444 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957803",
            "telephone_number": "801-253-5900"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-21",
        "last_updated": "2008-07-30",
        "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": "207Q00000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "3350",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Jordan Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 2008; 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.