NPIMap

Organization Active NPI

Ihc Health Services Inc.

Doing business as LDSH CC Midvalley-SLC

  • Multi-Specialty Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1952631772
Registry record updated Dec 29, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Multi-Specialty Clinic/CenterTaxonomy code 261QM1300X
Legal business name
IHC HEALTH SERVICES INC.
Doing business as
LDSH CC Midvalley-SLC
Practice address
333 S 900 E
Salt Lake City, UT 84102-2310
Phone
(801) 535-8163
Fax
(801) 355-3869
NPI assigned
Dec 29, 2009
Last updated
Dec 29, 2009By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 29, 2009

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

Authorized official

Name
Kelly J Howard
Title
Director
Phone
(801) 442-1425

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Multi-Specialty Clinic/Center 261QM1300X Primary

Addresses

Primary practice location

333 S 900 E
Salt Lake City, UT 84102-2310

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (801) 442-1400

Other names 1

  • LDSH CC Midvalley-SLC Doing business as

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

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

National Provider Directory

National Provider Directory
Tax ID family
Robert E Fowles MD482 organizations share this tax ID, including this one

Organizations with this tax ID in the same state 24

This tax ID family is large, so up to 24 of its organizations in the same state are linked here.

View all 24

NPI Registry JSON

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

{
    "created_epoch": "1262044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262044800000",
    "number": "1952631772",
    "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": "801-442-1400",
            "fax_number": "801-442-0638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "333 S 900 E",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022310",
            "telephone_number": "801-535-8163",
            "fax_number": "801-355-3869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-12-29",
        "last_updated": "2009-12-29",
        "status": "A",
        "authorized_official_last_name": "HOWARD",
        "authorized_official_first_name": "KELLY",
        "authorized_official_middle_name": "J",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-442-1425"
    },
    "taxonomies": [
        {
            "code": "261QM1300X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Multi-Specialty",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "LDSH CC Midvalley-SLC",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 29, 2009; 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.