NPIMap

Organization Active NPI

Ihc Health Services Inc

Doing business as South Cache Valley Clinic

  • Family Medicine Physician
  • Logan, UT
National Provider Identifier
1982748737
Registry record updated Jul 17, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Medicine PhysicianTaxonomy code 207Q00000X
License
3087 Issued in UT
Legal business name
IHC HEALTH SERVICES INC
Doing business as
South Cache Valley Clinic
Practice address
550 E 1400 N Ste X
Logan, UT 84341-2782
Phone
(435) 792-1600
NPI assigned
Feb 16, 2007
Last updated
Jul 17, 2008By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 17, 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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Family Medicine PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207Q00000X 3087 UT Primary
Obstetrics & Gynecology PhysicianGroup: 193200000X MULTI-SPECIALTY GROUP 207V00000X 3087 UT

Addresses

Primary practice location

550 E 1400 N Ste X
Logan, UT 84341-2782

Mailing address

PO Box 27128
Salt Lake City, UT 84127-0128
Phone (435) 792-1600

Other names 1

  • South Cache Valley Clinic 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": "1171584000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1216252800000",
    "number": "1982748737",
    "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": "435-792-1600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "550 E 1400 N STE X",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843412782",
            "telephone_number": "435-792-1600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "IHC HEALTH SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-07-17",
        "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": "207Q00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Family Medicine",
            "state": "UT",
            "license": "3087",
            "primary": true
        },
        {
            "code": "207V00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Obstetrics & Gynecology",
            "state": "UT",
            "license": "3087",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "South Cache Valley Clinic",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in Logan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 17, 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.