WAYNE COMMUNITY HEALTH CENTERS INC (NPI# 1568886000) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1568886000 |
| Entity Type | Organization |
| Organization Name | WAYNE COMMUNITY HEALTH CENTERS INC |
| Other Organization Name | KAZAN IVAN W MEMORIAL CLINIC |
| Practice Address |
570 E Moqui Ln Escalante UT 84726-0276 |
| Mailing Address |
Po Box 303 Bicknell UT 84715-0303 |
| Practice Telephone | 4358264374 |
| Mailing Telephone | 4354253744 |
| Mailing Fax Number | 4354253785 |
| Enumeration Date | 2014-02-04 |
| Last Update Date | 2016-11-29 |
| Authorized Official Name | EVAN CHRISTENSEN (EXECUTIVE DIRECTOR) |
| Authorized Official Telephone | 4354253744 |
| Is Organization Subpart | Y |
| Parent Organization Name | WAYNE COMMUNITY HEALTH CENTERS INC. |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 261QC1500X |
Clinic/Center Specialization: Community Health |
Ambulatory Health Care Facilities | ||
| N | 261QM1300X |
Clinic/Center Specialization: Multi-Specialty |
Ambulatory Health Care Facilities | ||
| Y | 261QF0400X |
Clinic/Center Specialization: Federally Qualified Health Center (FQHC) |
Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | MEDICARE PART B - | 000055193 | 01 |
| Other Name | Type Code |
|---|---|
| Kazan Ivan W Memorial Clinic | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962826362 | Wayne Community Health Centers Inc | Pharmacy | 65 N Center St, Escalante, UT 84726-0276 | 2014-02-06 |
| 1093863342 | Wayne Community Health Centers Inc | Clinic/Center | 30 South Hwy 95, Hanksville, UT 84734 | 2007-01-05 |
| 1093816282 | Wayne Community Health Centers Inc | Clinic/Center | 128 S 300 W, Bicknell, UT 84715 | 2006-09-26 |
| Street Address |
570 E MOQUI LN |
| City | ESCALANTE |
| State | UT |
| Zip Code | 84726-0276 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1497096457 | Jennifer Marie Evans | Pharmacist | 570 E Moqui Ln, Escalante, UT 84726-7753 | 2013-03-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1962826362 | Wayne Community Health Centers Inc | Pharmacy | 65 N Center St, Escalante, UT 84726-0276 | 2014-02-06 |
| 1619179751 | Garfield County | Clinic/Center | 65 N Center, Escalante, UT 84726-0276 | 2007-06-01 |
| 1952616591 | Turn-about Ranch, Inc. | Psychiatric Residential Treatment Facility | 280 North 300 East, Escalante, UT 84726-0345 | 2010-08-06 |
| 1114542388 | Acorn Care LLC | In Home Supportive Care | 60 E 100 N, Escalante, UT 84726-7828 | 2020-06-12 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871014092 | Wayne Community Health Centers, Inc | Clinic/Center | 65 North Center Street, Escalante, UT 84776-0276 | 2017-06-28 |
| 1134562903 | Mark William Anderson | Marriage & Family Therapist | 500 S. 580 W., Escalante, UT 84726 | 2013-04-11 |
| 1497096457 | Jennifer Marie Evans | Pharmacist | 570 E Moqui Ln, Escalante, UT 84726-7753 | 2013-03-14 |
| 1952616591 | Turn-about Ranch, Inc. | Psychiatric Residential Treatment Facility | 280 North 300 East, Escalante, UT 84726-0345 | 2010-08-06 |
| 1114542388 | Acorn Care LLC | In Home Supportive Care | 60 E 100 N, Escalante, UT 84726-7828 | 2020-06-12 |
| Taxonomy Code | 261QF0400X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Federally Qualified Health Center (FQHC) |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1871014092 | Wayne Community Health Centers, Inc | Clinic/Center | 65 North Center Street, Escalante, UT 84776-0276 | 2017-06-28 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1417305087 | Bear Lake Community Health Centers | Clinic/Center | 944 S State Highway 89, Logan, UT 84321-5436 | 2016-05-24 |
| 1780090944 | Southwest Utah Community Health Center, Inc. | Clinic/Center | 391 North 200 West, Hurricane, UT 84737-1616 | 2014-07-09 |
| 1548588247 | Southwest Utah Community Health Center, Inc | Clinic/Center | 74 W. Harding Ave, Cedar City, UT 84720 | 2010-05-06 |
| 1528128899 | Wasatch Homeless Health Care, Inc. | Clinic/Center | 409 W 400 S, Salt Lake City, UT 84101-1135 | 2006-12-09 |
| 1689754475 | Bear Lake Community Health Center | Clinic/Center | 325 W. Logan Hwy, Garden City, UT 84028-0328 | 2006-10-16 |
| 1942317722 | Green River Medical Center Inc | Clinic/Center | 585 West Main St., Box 417, Green River, UT 84525-0417 | 2006-08-25 |
| 1659358687 | Southwest Utah Community Health Center | Clinic/Center | 25 N 100 E, Suite 102, St George, UT 84770 | 2005-12-30 |
| 1366447112 | Community Health Centers Inc. | Clinic/Center | 1365 W 1000 N, Slc, UT 84116-1654 | 2005-06-17 |
| 1477558237 | Community Health Centers Inc. | Clinic/Center | 8446 Harrison St, Midvale, UT 84047-3568 | 2005-06-17 |
| 1144834771 | Carbon Medical Service Assocation, Incorporated | Clinic/Center | 305 Center St, East Carbon, UT 84520-7726 | 2020-09-01 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on WAYNE COMMUNITY HEALTH CENTERS INC.
| 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.