Ihc Health Services Inc

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

IHC HEALTH SERVICES INC

Doing business as

Intermountain Health Hospice Cassia

Practice address

1501 Hiland Ave Ste Z
Burley, ID 83318-2688

Phone

(208) 677-6314

NPI assigned

Nov 21, 2006

Last updated

Jan 29, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mark Provan

Title

VP-Homecare Hospice Palliative Care

Phone

(801) 442-2000

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Intermountain Health Hospice Cassia Doing business as

Medicare fee-for-service enrollment

Enrolled in ID

Enrollment records 1

NPI to CCN mapping 1

The Medicare certification numbers (CCNs) connected to NPI 1972678316. Details of each certification follow.

• CCN 131542 Hospice · Active · Details

Hospice certification: CCN 131542

Legal name

IHC HEALTH SERVICES INC

Doing business as

INTERMOUNTAIN HEALTH HOSPICE - CASSIA

Certification status

Active

Provider type (POS)

Hospice

Participating since

Nov 27, 2002

Last certification

Dec 10, 2020

Ownership / control type

Non-Profit - Private

Organization structure

CorporationNon-profit

Enrollment address

1501 Hiland Ave
Ste Z
Burley, ID 83318-2688

Listed as

Intermountain Homecare Hospice - CassiaCCN 131542 · All quality measures

Ownership

For-Profit

Certified

Nov 27, 2002

Medicare certification status

ActiveFrom the Provider of Services file

Locations

All disclosed owners & managing parties 15

As disclosed on the Medicare enrollment (CMS All Owners files). Individuals include officers, directors and managing employees, who may not hold ownership.

Owners & managing parties with NPI records 3

Owners and managing parties disclosed on this facility’s Medicare enrollment that are themselves Medicare-enrolled.

• Benjamin Joseph Romney, M.D.

  • Family Medicine Physician
  • Burley, ID
  • NPI 1851771471

  Operational/Managerial Control

  CMS ownership
• Shannon Cooke Baker, M.D.

  • Family Medicine Physician
  • West Jordan, UT
  • NPI 1518025360

  Corporate Director

  CMS ownership
• William Thomas Caine, MD

  • Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
  • Murray, UT
  • NPI 1811075278

  Corporate Director

  CMS ownership

All facility ownership & control disclosures 44

Facilities whose Medicare enrollment lists this provider’s PECOS associate ID as an owner or managing party.

Affiliated clinicians 2

Clinicians who list this facility as an affiliation in Medicare Care Compare.

• Dallon Ray, DO

  • Family Medicine Physician
  • Burley, ID
  • NPI 1316696966

  Hospice

  Care Compare affiliation
• Benjamin Joseph Romney, M.D.

  • Family Medicine Physician
  • Burley, ID
  • NPI 1851771471

  Hospice

  Care Compare affiliation

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1738108800000",
    "number": "1972678316",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11520 S REDWOOD RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840957805",
            "telephone_number": "385-887-6000",
            "fax_number": "801-442-0603"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1501 HILAND AVE STE Z",
            "city": "BURLEY",
            "state": "ID",
            "postal_code": "833182688",
            "telephone_number": "208-677-6314"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-21",
        "last_updated": "2025-01-29",
        "certification_date": "2025-01-29",
        "status": "A",
        "authorized_official_last_name": "PROVAN",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "VP-HOMECARE HOSPICE PALLIATIVE CARE",
        "authorized_official_telephone_number": "801-442-2000"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1972678316",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Intermountain Health Hospice Cassia",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Ihc Health Services Inc (Cassia Regional Hospital Physicians)
• Ihc Health Services Inc (Cassia Primary Care)
• Ihc Health Services Inc (Intermountain Health Home Health Cassia)
• Ihc Health Services Inc (CRMC Family Medicine)
• Ihc Health Services Inc
• Ihc Health Services, Inc. (Intermountain Health Cassia Regional Hospital)
• Independent Growth
• Intermountain Medical Group Denver, LLC
• Christian Jackson
• Duane Jeffers, MD

• Community Based Hospice Care Agency in Burley, ID
• Providers in Burley, ID by specialty
• Community Based Hospice Care Agency in Idaho

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 29, 2025; 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.