IHC HEALTH SERVICES INC (NPI# 1053664680) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1053664680 |
| Entity Type | Organization |
| Organization Name | IHC HEALTH SERVICES INC |
| Other Organization Name | INTERMOUNTAIN PEDIATRIC IMAGING |
| Practice Address |
100 Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Mailing Address |
Po Box 27128 Salt Lake City UT 84127-0128 |
| Practice Telephone | 8014423156 |
| Mailing Telephone | 8014423156 |
| Enumeration Date | 2012-10-19 |
| Last Update Date | 2012-10-22 |
| Authorized Official Name | LINDA C LECKMAN (CEO INTERMOUNTAIN MEDICAL GROUP) |
| Authorized Official Telephone | 8014423974 |
| Authorized Official Credential | MD |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085P0229X |
Radiology Specialization: Pediatric Radiology |
4802012 | UT | Allopathic & Osteopathic Physicians |
| Other Name | Type Code |
|---|---|
| Intermountain Pediatric Imaging | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942828520 | Ihc Health Services Inc | Psychologist | 5373 S Green St Ste 400, Murray, UT 84123-4740 | 2020-07-09 |
| 1194343095 | Ihc Health Services Inc | Internal Medicine | 5217 S State St Ste 250, Murray, UT 84107-4943 | 2020-07-08 |
| 1639797509 | Ihc Health Services Inc | Internal Medicine | 4387 Harrison Blvd Ste C1, Ogden, UT 84403-3148 | 2020-07-08 |
| 1124661384 | Ihc Health Services Inc | General Acute Care Hospital | 765 E Marketplace Dr, Spanish Fork, UT 84660 | 2019-10-21 |
| 1881166361 | Ihc Health Services Inc | Clinic/Center | 201 W Layton Pkwy Ste 1a, Layton, UT 84041-3692 | 2018-12-21 |
| 1235626698 | Ihc Health Services Inc | Clinic/Center | 1485 S Highway 40 Ste G, Heber City, UT 84032-3522 | 2018-04-20 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
| 1851807333 | Ihc Health Services Inc | Family Medicine | 380 W 1230 N, Ste 602, Provo, UT 84604 | 2017-12-20 |
| 1770099251 | Ihc Health Services Inc | Dermatology | 395 W Bulldog Blvd Ste 604, Provo, UT 84604-3331 | 2017-12-20 |
| 1689180218 | Ihc Health Services Inc | Pediatrics | 395 W Bulldog Blvd Ste 703, Provo, UT 84604 | 2017-12-19 |
| Street Address |
100 MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
| 1235535485 | Ihc Health Services Inc | Clinic/Center | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-17 |
| 1508262833 | Aimee Brierley | Occupational Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-13 |
| 1801290986 | Jeffery Zobell | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-10-17 |
| 1336542778 | Bevan Jensen | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-09-30 |
| 1699183152 | Kristina Rogers | Dentist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-07-29 |
| 1548677297 | Stephanie Eva Wisniewski | Speech-Language Pathologist | 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 | 2014-07-15 |
| 1184044877 | Adam Wesley Dell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-04-21 |
| 1225456718 | Bhanu Muniyappa | Pediatrics | 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 | 2014-04-01 |
| 1265850952 | Kristina Gulliver | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 2085P0229X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Pediatric Radiology |
| A radiologist who is proficient in all forms of diagnostic imaging as it pertains to the treatment of diseases in the newborn, infant, child and adolescent. This specialist has knowledge of both imaging and interventional procedures related to the care and management of diseases of children. A pediatric radiologist must be highly knowledgeable of all organ systems as they relate to growth and development, congenital malformations, diseases peculiar to infants and children and diseases that begin in childhood but cause substantial residual impairment in adulthood. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Board of Radiology, 2007. http://www.theabr.org/. American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification - Board certification for Medical Doctors (MDs) is provided by the American Board of Radiology. Board certification for Doctors of Osteopathy (DOs) is provided by the American Osteopathic Board of Radiology. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1720198716 | William D. Winters | Radiology | 100 No Mario Capecchi Dr., Salt Lake City, UT 84113 | 2006-08-30 |
| 1215940465 | Karin L. Hoeg | Radiology | 100 No. Mario Capecchi Dr., Salt Lake City, UT 84113 | 2006-08-15 |
| 1730394131 | Ryan W. Arnold | Radiology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-05-11 |
| 1083739270 | Henry J Baskin Jr. | Radiology | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2007-03-20 |
| 1790875300 | Kathleen Ann Murray | Radiology | Fairfax Road At Virginia Street, Shriners Hosptials for Children, Salt Lake City, UT 84103-4399 | 2006-10-13 |
| 1447351978 | Giosue Peter Feola | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1063513596 | Constance K Maves | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1154422681 | Gary L Hedlund | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-26 |
| 1306940739 | Kevin R Moore | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-09-07 |
| 1861502254 | Pediatric Radiology, P.C. | Radiology | 100 N Medical Dr, Salt Lake City, UT 84113-1103 | 2006-08-30 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.