Ihc Health Services Inc
Organization Active NPI Family Medicine Physician · South Jordan, UT
NPI 1871990309 · NPPES record last updated Feb 10, 2015
Key facts
- NPI
- 1871990309
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 770172014 (UT)
- Legal business name
- IHC HEALTH SERVICES INC
- Practice address
- 1067 W South Jordan Pkwy
South Jordan, UT 84095-8809 - Phone
- (385) 887-7200
- NPI assigned
- Nov 26, 2014
- Organization subpart
- No
Authorized official
- Name
- Linda C Leckman, MD
- Title
- Ceo Intermountain Medical Group
- Phone
- (801) 442-3974
Corporate family (same tax ID) 24
Practitioners 10
-
Colton Bennett, PA-C
-
Samantha Lyn Clarkson, FNP-C
-
Robert Duncan, DO
-
Cory Ferguson, M.D.
-
Monica L Hatch, PA-C
-
Kirsti Rinne, W.H.N.P
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in UT
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| 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
- Tax ID family
- Bradley S Thompson DO
Locations
1091 W South Jordan Pkwy
Ste 500
South Jordan, UT 84095
Phone (385) 887-7200
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 770172014 | UT | Yes |
Addresses
Primary practice location
1067 W South Jordan Pkwy
South Jordan, UT 84095-8809
Mailing address
PO Box 27128
Salt Lake City, UT 84127-0128
Phone (385) 887-7200
Other names
- South Jordan WorkMed
Other providers in South Jordan, UT
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All providers in South Jordan, UT · Family Medicine 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 Feb 10, 2015. 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.