CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION (NPI# 1396199972) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1396199972 |
| Entity Type | Organization |
| Organization Name | CONFEDERATED TRIBES OF THE GOSHUTE RESERVATION |
| Practice Address |
Hc 61 Box 6104 Ibapah UT 84034-6003 |
| Practice Telephone | 4352341138 |
| Mailing Telephone | 4352341138 |
| Enumeration Date | 2016-04-20 |
| Last Update Date | 2016-04-20 |
| Authorized Official Name | VIRGIL W JOHNSON (COUNCIL CHAIR) |
| Authorized Official Telephone | 8018984814 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261Q00000X | Clinic/Center | Ambulatory Health Care Facilities | ||
| Y | 261Q00000X | Clinic/Center | 9453799-8906 | UT | Ambulatory Health Care Facilities |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750510277 | Confederated Tribes of The Goshute Reservation | General Practice | 195 Tribal Center Rd, Ibapah, UT 84034 | 2009-07-06 |
| 1194189233 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 | 2016-04-05 |
| 1265892012 | Confederated Tribes of The Goshute Reservation | Clinical Medical Laboratory | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2016-03-07 |
| 1003275280 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2016-02-17 |
| 1467811562 | Confederated Tribes of The Goshute Reservation | Pharmacy | 660 S 200 E, Salt Lake City, UT 84111-3835 | 2016-02-17 |
| 1174969125 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2013-05-17 |
| 1992141964 | Confederated Tribes of The Goshute Reservation | Clinic/Center | 660 S 200 E, Suite 250, Salt Lake City, UT 84111-3835 | 2013-05-17 |
| 1003251638 | Confederated Tribes of The Goshute Reservation | Pharmacy | 660 S 200 E Ste 250, Salt Lake City, UT 84111-3846 | 2013-05-09 |
| Street Address |
HC 61 BOX 6104 |
| City | IBAPAH |
| State | UT |
| Zip Code | 84034-6003 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750510277 | Confederated Tribes of The Goshute Reservation | General Practice | 195 Tribal Center Rd, Ibapah, UT 84034 | 2009-07-06 |
| 1508296310 | Confederated Tribes of The Goshute Indian Reservation | Non-emergency Medical Transport (VAN) | 195 Tribal Center Rd, Ibapah, UT 84034 | 2013-11-14 |
| 1033735568 | Haley N Linares | Behavior Technician | 9115 Ibapah Rd, Ibapah, UT 84034-6024 | 2020-06-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033735568 | Haley N Linares | Behavior Technician | 9115 Ibapah Rd, Ibapah, UT 84034-6024 | 2020-06-20 |
| 1750510277 | Confederated Tribes of The Goshute Reservation | General Practice | 195 Tribal Center Rd, Ibapah, UT 84034 | 2009-07-06 |
| 1508296310 | Confederated Tribes of The Goshute Indian Reservation | Non-emergency Medical Transport (VAN) | 195 Tribal Center Rd, Ibapah, UT 84034 | 2013-11-14 |
| Taxonomy Code | 261Q00000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| A facility or distinct part of one used for the diagnosis and treatment of outpatients. "Clinic/Center" is irregularly defined, sometimes being limited to organizations serving specialized treatment requirements or distinct patient/client groups (e.g., radiology, poor, and public health). |
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|---|---|---|---|---|
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| 1376166561 | Nuna Munay | Clinic/Center | 9525 S Tramway Dr, Sandy, UT 84092-3108 | 2020-05-21 |
| 1679193338 | Uintah Basin Medical Center | Clinic/Center | 50 S 200 E, Duchesne, UT 84021 | 2020-04-23 |
| 1225658800 | Provider Services Network, Inc. | Clinic/Center | 765 E 340 S Ste 206, American Fork, UT 84003-3310 | 2020-04-23 |
| 1578100186 | 124 South Fairfield LLC | Clinic/Center | 124 S Fairfield Rd Ste B, Layton, UT 84041-7106 | 2019-12-02 |
| 1710468384 | Skull Valley Health Clinic | Clinic/Center | 1929 Aaron Dr Ste I, Tooele, UT 84074-8112 | 2018-08-22 |
| 1275021784 | Axis Chiropractic and Massage Clinic, LLC | Clinic/Center | 1681 W 3860 S Ste 106, West Valley City, UT 84119-6274 | 2018-04-30 |
| 1760979397 | Moenkopi Counseling PC | Clinic/Center | 230 N 1680 E Ste H2, Saint George, UT 84790-2585 | 2018-04-19 |
| 1669978896 | Southern Utah Vision Care Pllc | Clinic/Center | 1251 Northfield Rd Ste 215, Cedar City, UT 84721-8623 | 2018-04-05 |
| 1407359078 | Ihc Health Services Inc | Clinic/Center | 380 W Bulldog Blvd, Ste 403, Provo, UT 84604 | 2018-03-09 |
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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.