REVERE HEALTH – NPI #1942233986
Clinic/Center

REVERE HEALTH is an AHC clinic located in SALEM, UT. NPPES has assigned the NPI number 1942233986 to REVERE HEALTH on July 09, 2006. It is a Type-2 NPI, indicating this NPI number is associated with an organization. Since the name “REVERE HEALTH” is a dba name, the actual legal business name for this organization is CENTRAL UTAH CLINIC, P.C.. The primary taxonomy selected by this provider is 261QM1300X from the Health Care Provider Taxonomy code set, which is classified as Clinic/Center, specializing in Multi-Specialty

The NPI profile was previously updated about 6 years ago on Jan 14, 2020. 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 REVERE HEALTH below.

NPI Profile for
CENTRAL UTAH CLINIC, P.C.

NPI Number
1942233986
Enumeration Date

(about 20 years ago)
Entity Type
Type-2  Organization
Organization health care providers may have a single employee or thousands of employees. An example is an incorporated individual who is an organization's only employee.
Legal Name
CENTRAL UTAH CLINIC, P.C.
Doing Business As (dba): REVERE HEALTH
Primary location
555 W SR 164
SALEM, UT 84653
Phone: (801) 429-8000 Fax:
Mailing address
1055 N 500 W
ATTN: CREDENTIALING
PROVO, UT 84604-3305
Phone: (801) 354-8225 Fax: (801) 418-0941
Organization Subpart
No
Authorized Official
JED HARSTON
DIRECTOR OF MANAGED CARE
Phone: (801) 812-5012
Updated
Certification Date
Jan 14, 2020

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.

Taxonomy Code(s)

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
261QM1300X
- Clinic/Center / Multi-Specialty (Primary)

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.

Endpoint

Health Information Exchange (HEI)

HEI is the mobilization of health care information electronically across organizations within a region, community or hospital system. Endpoints provide a simple and secure way for participants to send authenticated, encrypted health information directly to known, trusted recipients over the internet such as primary care physicians, specialists, hospitals, labs, etc.

Endpoint
[email protected]
Endpoint type
Direct Messaging Address
Endpoint Description
Content Type
Affiliation
N
Endpoint Location
555 W SR 164,
SALEM, UT 77025-1669