Ellis R. Shipp Medical Clinic
LBN: Community Health Centers, Inc.
Ellis R. Shipp Medical Clinic is an health care organization with primary practice located at 4535 S 5600 W , West Valley City UT 84120-4639. The organization recently has 5 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Family Medicine, Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Pediatrics, Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC), Ambulatory Health Care Facilities / Multi-Specialty. Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) is the primary health care specialty.
Community Health Centers, Inc. can be contacted via phone (801) 676-4405, or through Thomas, Jennifer via phone (801) 412-6920.
Contact Information
Primary practice address
4535 S 5600 W
West Valley City UT 84120-4639
Phone: (801) 676-4405
Fax: (877) 497-4661
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | ||
| Allopathic & Osteopathic Physicians / Obstetrics & Gynecology | 207V00000X | ||
| Allopathic & Osteopathic Physicians / Pediatrics | 208000000X | ||
| Ambulatory Health Care Facilities / Federally Qualified Health Center (FQHC) | 261QF0400X | ||
| Ambulatory Health Care Facilities / Multi-Specialty | 261QM1300X |
Profile Details
| NPI number | 1326417445 |
|---|---|
| LBN Legal business name | Community Health Centers, Inc. |
| DBA Doing business as | Ellis R. Shipp Medical Clinic |
| Authorized official | Thomas, Jennifer |
| Entity | Organization |
| Organization subpart 1 | No |
| Enumeration date | Sep 18th, 2015 |
| Last updated | Oct 30th, 2023 - about last year |
1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1326417445 | NPPES |
| Utah | MEDICAID | 1326417445 |
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