NPIMap

Organization Active NPI

Uintah Basin Medical Center

Doing business as The Clinic UBH Roosevelt

  • Rural Health Clinic/Center
  • Roosevelt, UT
National Provider Identifier
1851920151
Registry record updated Aug 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Rural Health Clinic/CenterTaxonomy code 261QR1300X
Legal business name
UINTAH BASIN MEDICAL CENTER
Doing business as
The Clinic UBH Roosevelt
UBMC Clinic
Practice address
250 W 300 N
Roosevelt, UT 84066-2336
Phone
(435) 725-7448
Fax
(435) 722-9291
NPI assigned
Apr 7, 2020
Last updated
Aug 10, 2026By the provider in NPPES
Organization subpart
Yes
Parent organization
UINTAH BASIN MEDICAL CENTERAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Aug 10, 2026

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

Authorized official

Name
James Marshall
Title
Ceo
Phone
(435) 725-7448

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X NU
Rural Health Clinic/Center 261QR1300X NU Primary

Addresses

Primary practice location

250 W 300 N
Roosevelt, UT 84066-2336

Mailing address

250 W 300 N
Roosevelt, UT 84066-2336
Phone (435) 725-7448

Other names 2

  • The Clinic UBH Roosevelt Doing business as
  • UBMC Clinic Doing business as

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200519000819 UT Part A Provider - Rural Health Clinic 0244131944 Practice locations: Roosevelt, UT

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1851920151. Details of each certification follow.

Rural health clinic certification: CCN 463994

Legal name
UINTAH BASIN MEDICAL CENTER
Doing business as
UINTAH BASIN MEDICAL CENTER THE CLINIC ROOSEVELT
Certification status
Active
Provider type (POS)
Rural health clinic
Participating since
Dec 11, 2020
Last certification
Dec 11, 2020
Ownership / control type
2B
Organization structure
CorporationNon-profit
Incorporated
Aug 14, 1944 in UT
Enrollment address
250 W 300 N
Roosevelt, UT 84066-2336
Related CCNs
460019

Facilities connected through Provider of Services related, parent or unit certification numbers.

Other NPIs with the same Medicare PAC ID 8

NPIs whose Medicare enrollments share a PECOS associate control ID (the same enrolled entity).

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
46D2288619Ubmc Clinic250 W 300 N, Roosevelt, UT 84066Provider-performed microscopyAug 28, 2027

National Provider Directory

National Provider Directory
Tax ID family
Duchesne Co Hosp12 organizations share this tax ID, including this one
Part of
Duchesne Co Hosp

Other organizations with this tax ID 11

Organizations that report the same tax identification number in the National Provider Directory.

Ownership & related parties

All disclosed owners & managing parties 17

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

NameRoleSinceShare
Uintah Basin Medical Center Organization, Roosevelt, UT Corporation, Non-profit 5% Or Greater Direct Ownership Interest Apr 14, 2020 100%
Sean David Paulsen Individual Corporate DirectorBoard Member Apr 28, 2020
Tyler Rasmussen Individual Corporate DirectorBoard Member Apr 28, 2020
Bob Gilbert Individual Corporate DirectorBoard Member Apr 28, 2020
Brent H Hales Individual Corporate OfficerCfo Apr 28, 2020
Preston D Marx Individual Corporate OfficerVP of Information Technology Apr 28, 2020
Tim Negus Individual Corporate DirectorBoard Member Apr 28, 2020
Irene Hansen Individual Corporate DirectorBoard Member Apr 28, 2020
Roger K Marett Individual Corporate OfficerVP of Physician Services Oct 29, 2014
Alarik Myrin Individual Corporate DirectorBoard Member Apr 28, 2020
Bobby C Richardson Individual Corporate OfficerCno Apr 28, 2020
Roger O Burton Individual Corporate OfficerCfo Apr 28, 2020
Shelley Fenn Individual Corporate DirectorBoard Member Apr 28, 2020
Tyler Allred Individual Corporate DirectorBoard Member Apr 28, 2020
James I Marshall Individual Corporate OfficerCeo Oct 12, 2014
W-2 Managing EmployeeCeo Oct 1, 2014
Randall C Bennett Individual Corporate OfficerVice President Apr 28, 2020
Jason J Larson Individual Corporate DirectorBoard Member Apr 28, 2020

Owners & managing parties with NPI records 10

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

All facility ownership & control disclosures 3

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

FacilityTypeRoleSince
Uintah Basin Rehabilitation and Senior VillaRoosevelt, UT, CCN 465084 Skilled nursing facility Operational/Managerial Control (100%)
Adp of the SNF		 May 31, 2016
May 31, 2016
Uintah Basin Medical Center the Clinic DuchesneDuchesne, UT, CCN 463995 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Apr 14, 2020
Uintah Basin Medical Center the Clinic VernalVernal, UT, CCN 463997 Rural health clinic 5% Or Greater Direct Ownership Interest (100%) Oct 12, 2014

Owned or controlled facilities with NPI records 3

Facilities whose Medicare enrollment lists this provider as an owner, officer, director or managing party.

Facilities with the same owner 3

Facilities that share an organizational owner with 5% or greater ownership or operational control.

NPI Registry JSON

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

{
    "created_epoch": "1586217600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1786320000000",
    "number": "1851920151",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-725-7448",
            "fax_number": "435-722-9291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 W 300 N",
            "city": "ROOSEVELT",
            "state": "UT",
            "postal_code": "840662336",
            "telephone_number": "435-725-7448",
            "fax_number": "435-722-9291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UINTAH BASIN MEDICAL CENTER",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "UINTAH BASIN MEDICAL CENTER",
        "enumeration_date": "2020-04-07",
        "last_updated": "2026-08-10",
        "certification_date": "2026-08-10",
        "status": "A",
        "authorized_official_last_name": "MARSHALL",
        "authorized_official_first_name": "JAMES",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "435-725-7448"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "261QR1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rural Health",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "The Clinic UBH Roosevelt",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "UBMC Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Roosevelt, UT

Sources for this page

Verify at the official NPI Registry.