NPIMap

Organization Active NPI

Utah Navajo Health System, Incorporated

Doing business as Montezuma Creek Community Health Center

  • Family Medicine Physician
  • Montezuma Creek, UT
National Provider Identifier
1932386612
Registry record updated Jun 11, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
Legal business name
UTAH NAVAJO HEALTH SYSTEM, INCORPORATED
Doing business as
Montezuma Creek Community Health Center
Practice address
East Highway 262
Montezuma Creek, UT 84534
Phone
(435) 651-3291
Fax
(435) 651-3291
NPI assigned
Jan 25, 2008
Last updated
Jun 11, 2019By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 11, 2019

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

Authorized official

Name
Mr. Michael Jensen
Title
Chief Executive Officer
Phone
(435) 651-3713

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine Physician 207Q00000X NU Primary

Addresses

Primary practice location

East Highway 262
Montezuma Creek, UT 84534

Mailing address

PO Box 130
Montezuma Creek, UT 84534
Phone (435) 651-3291

Other identifiers 1

IdentifierTypeStateIssuer
1811991151MedicaidUT

Other names 1

  • Montezuma Creek Community Health Center Doing business as

National Provider Directory

National Provider Directory
Tax ID family
Utah Navajo Health System Inc15 organizations share this tax ID, including this one

Other organizations with this tax ID 14

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

View all 14

NPI Registry JSON

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

{
    "created_epoch": "1201219200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1932386612",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 130",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "84534",
            "telephone_number": "435-651-3291",
            "fax_number": "435-651-3291"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "EAST HIGHWAY 262",
            "city": "MONTEZUMA CREEK",
            "state": "UT",
            "postal_code": "84534",
            "telephone_number": "435-651-3291",
            "fax_number": "435-651-3291"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "UTAH NAVAJO HEALTH SYSTEM, INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-25",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "JENSEN",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "435-651-3713",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "207Q00000X",
            "taxonomy_group": "",
            "desc": "Family Medicine",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1811991151",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Montezuma Creek Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        },
        {
            "organization_name": "Montezuma Creek Community Health Center",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Montezuma Creek, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.