Zion Intermediate Care Inc

Primary specialty

Intellectual Disabilities Intermediate Care FacilityTaxonomy code 315P00000X

Legal business name

ZION INTERMEDIATE CARE INC

Practice address

4028 S 4800 W
West Valley, UT 84120-4537

Phone

(801) 968-8122

NPI assigned

Oct 2, 2023

Organization subpart

No

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

Authorized official

Name

Misti Buck, ADMINISTRATOR

Title

President

Phone

(801) 473-7042

Specialties & licenses 1

Addresses

Other names 1

• Zion IC Other name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Intermediate care facility for individuals with intellectual disabilities certification: CCN 46G017

Legal name

ZION INTERMEDIATE CARE, INC WEST

Certification status

Active

Provider type (POS)

Intermediate care facility for individuals with intellectual disabilities

Participating since

Dec 11, 1987

Last certification

Nov 18, 2025

Beds

16

Ownership / control type

Private (proprietary)

Facility address

4028 South 4800 West
West Valley City, UT 84120

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

CLIA laboratory certificates

Tax ID family

Zion Ic2 organizations share this tax ID, including this one

Other organizations with this tax ID 1

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

• Zion Intermediate Care Inc

  • Intellectual Disabilities Intermediate Care Facility
  • Bountiful, UT
  • NPI 1396525903
  NPD tax ID

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

{
    "created_epoch": "1696204800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696204800000",
    "number": "1881474484",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "119 S PACIFIC DR STE 109",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032399",
            "telephone_number": "801-763-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4028 S 4800 W",
            "city": "WEST VALLEY",
            "state": "UT",
            "postal_code": "841204537",
            "telephone_number": "801-968-8122"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ZION INTERMEDIATE CARE INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-02",
        "last_updated": "2023-10-02",
        "certification_date": "2023-10-02",
        "status": "A",
        "authorized_official_last_name": "BUCK",
        "authorized_official_first_name": "MISTI",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-473-7042",
        "authorized_official_credential": "ADMINISTRATOR"
    },
    "taxonomies": [
        {
            "code": "315P00000X",
            "taxonomy_group": "",
            "desc": "Intermediate Care Facility, Intellectual Disabilities",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Zion IC",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Benjamin Wilson, D.M.D.
• Hayden Winegar
• Brenda M Woodhouse
• Robert Taylor World Jr.
• Katie Yanguez, FNP
• Jason O Zumwalt, RN

• Intellectual Disabilities Intermediate Care Facility in West Valley, UT
• Providers in West Valley, UT by specialty
• Intellectual Disabilities Intermediate Care Facility in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; facility enrollments, owners and changes of ownership; Provider of Services certification data.
• 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.