NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Utah Valley Senior Medicine

  • Geriatric Medicine (Internal Medicine) Physician
  • Provo, UT
National Provider Identifier
1851807333
Registry record updated Jan 7, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Geriatric Medicine (Internal Medicine) PhysicianTaxonomy code 207RG0300X
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Utah Valley Senior Medicine
Practice address
395 W Cougar Blvd Ste 602
Provo, UT 84604-3331
Phone
(801) 357-7250
NPI assigned
Dec 20, 2017
Last updated
Jan 7, 2021By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 7, 2021

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

Authorized official

Name
Dr. Mark Briesacher, MD
Title
SVP - Chief Phy Executive
Phone
(801) 442-3495

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X NU
Geriatric Medicine (Internal Medicine) Physician 207RG0300X NU Primary

Addresses

Primary practice location

395 W Cougar Blvd Ste 602
Provo, UT 84604-3331

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 373-3300

Other practice location 1

380 W 1230 N
Ste 602
Provo, UT 84604
Phone (801) 373-3300

Other names 1

  • Utah Valley Senior Medicine Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
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

National Provider Directory
Tax ID family
Robert E Fowles MD482 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.

View all 24

Locations

852 N 500 W
Provo, UT 84604
Phone (801) 357-4417

Practitioners & affiliated clinicians

Practitioners 8

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.

NPI Registry JSON

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

{
    "created_epoch": "1513728000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1609977600000",
    "number": "1851807333",
    "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": "801-373-3300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "395 W COUGAR BLVD STE 602",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846043331",
            "telephone_number": "801-357-7250"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "380 W 1230 N",
            "address_2": "Ste 602",
            "address_purpose": "LOCATION",
            "city": "Provo",
            "state": "UT",
            "postal_code": "84604",
            "country_code": "US",
            "telephone_number": "801-373-3300",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2017-12-20",
        "last_updated": "2021-01-07",
        "certification_date": "2021-01-07",
        "status": "A",
        "authorized_official_last_name": "BRIESACHER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "SVP - CHIEF PHY EXECUTIVE",
        "authorized_official_telephone_number": "801-442-3495",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "207RG0300X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Geriatric Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Utah Valley Senior Medicine",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Provo, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 7, 2021; 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.