NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as Intermountain Redrock Pediatrics

  • Pediatrics Physician
  • St George, UT
National Provider Identifier
1922136126
Registry record updated Jul 30, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatrics PhysicianTaxonomy code 208000000X
License
00009023 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
Intermountain Redrock Pediatrics
Practice address
1380 E Medical Center Dr
#3100
St George, UT 84790-2123
Phone
(435) 251-2740
NPI assigned
Mar 1, 2007
Last updated
Jul 30, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 30, 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 3

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatrics PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 208000000X 00009023 UT Primary
Pediatric Adolescent Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080A0000X 00009023 UT
Pediatric Gastroenterology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 2080P0206X 00009023 UT

Addresses

Primary practice location

1380 E Medical Center Dr
#3100
St George, UT 84790-2123

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 251-2740

Other names 1

  • Intermountain Redrock Pediatrics 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

Practitioners & affiliated clinicians

Practitioners 14

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.

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1172707200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1217376000000",
    "number": "1922136126",
    "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": "435-251-2740"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1380 E MEDICAL CENTER DR",
            "address_2": "#3100",
            "city": "ST GEORGE",
            "state": "UT",
            "postal_code": "847902123",
            "telephone_number": "435-251-2740"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-03-01",
        "last_updated": "2008-07-30",
        "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": "208000000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics",
            "state": "UT",
            "license": "00009023",
            "primary": true
        },
        {
            "code": "2080A0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Adolescent Medicine",
            "state": "UT",
            "license": "00009023",
            "primary": false
        },
        {
            "code": "2080P0206X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Pediatrics, Pediatric Gastroenterology",
            "state": "UT",
            "license": "00009023",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Redrock Pediatrics",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in St George, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 30, 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.