NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Midvale ExpressCare

  • Community Health Registered Nurse
  • Midvale, UT
National Provider Identifier
1891825170
Registry record updated Jul 31, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community Health Registered NurseTaxonomy code 163WC1500X
License
49161 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Midvale ExpressCare
Practice address
980 Fort Union Blvd
Midvale, UT 84047-1714
Phone
(801) 563-7434
NPI assigned
Mar 6, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 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
Community Health Registered NurseGroup: 193400000X SINGLE SPECIALTY GROUP 163WC1500X 49161 UT Primary

Addresses

Primary practice location

980 Fort Union Blvd
Midvale, UT 84047-1714

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 563-7434

Other names 1

  • Midvale ExpressCare 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

National Provider Directory

National Provider Directory

Locations

5171 S Cottonwood St
South Salt Lake, UT 84107
Phone (801) 507-4000

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1173139200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217462400000",
    "number": "1891825170",
    "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": "801-563-7434"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "980 FORT UNION BLVD",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840471714",
            "telephone_number": "801-563-7434"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-06",
        "last_updated": "2008-07-31",
        "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": "163WC1500X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Registered Nurse, Community Health",
            "state": "UT",
            "license": "49161",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Midvale ExpressCare",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2008; 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.