72ND STREET MEDICAL CLINIC – NPI #1073611364
Clinic/Center
72ND STREET MEDICAL CLINIC is an AHC clinic located in MIDVALE, UT. NPPES has assigned the NPI number 1073611364 to 72ND STREET MEDICAL CLINIC on September 20, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “72ND STREET MEDICAL CLINIC” is a dba name, the actual legal business name for this organization is COMMUNITY HEALTH CENTERS, INC.. With multiple taxonomy codes selected, the primary taxonomy selected by this provider is 261QF0400X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Federally Qualified Health Center (FQHC) Bear in mind that having a taxonomy code selected doesn't replace any credentialing or validation process that may be required by law.
The NPI profile was previously updated about 3 years ago on Oct 30, 2023. Use the NPI data found here to bill health insurance companies, identify providers enrolled in Medicare and Medicaid services or other HIPAA compliant transactions. See the complete NPI profile for 72ND STREET MEDICAL CLINIC below.
NPI Profile for
COMMUNITY HEALTH CENTERS, INC.
(more than 19 years ago)
SUITE A
MIDVALE, UT 84047-1043 Phone: (801) 566-5494 Fax: (877) 497-4661
WEST VALLEY CITY, UT 84119-7219 Phone: (801) 412-6920 Fax: (877) 497-4661
EXECUTIVE DIRECTOR
Phone: (801) 412-6920
Note: NPPES allows providers to attest to the accuracy of their NPI data. When a provider request any change to the NPI record, they will be able to attest to their changed NPI data, resulting in an updated certification date.
Identifiers for 72ND STREET MEDICAL CLINIC
Identifiers are used to associate other provider identifiers such as Medicaid or other insurers (ie:, Blue Cross, Blue Shield, Aetna, Kaiser-Permanente, etc.), with their NPI number. These identifiers can be used in matching an NPI number to an insurer's records. However, not all providers have such numbers and not all providers choose to include them in their NPI information.
| Description | Issuer | State | Identifier |
|---|---|---|---|
| medicaid | UT | 1073611364 |
A taxonomy code is a code that describes the health care service provider's type, classification, and the area of specialization. The primary specialty for this provider is indicated as (Primary) below.
| Taxonomy Classification / Specialization | State | License |
|---|---|---|
| 261QF0400X - Clinic/Center / Federally Qualified Health Center (FQHC) (Primary) |
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| 363L00000X - Nurse Practitioner |
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| 363A00000X - Physician Assistant |
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| 261QM1300X - Clinic/Center / Multi-Specialty |
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| 208000000X - Pediatrics |
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| 207V00000X - Obstetrics & Gynecology |
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| 207Q00000X - Family Medicine |
The taxonomy codes are selected by the provider at the time of NPI registration. Selection of a taxonomy code does not replace any credentialing or validation process that the provider requesting the code should complete.