Midtown Community Health Center Children's Clinic – Federally Qualified Health Center (FQHC), NPI 1013186717
Federally Qualified Health Center (FQHC)
Main info
Profile Insights
NPPES metrics only — not quality of care.
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Provider Addresses for Midtown Community Health Center Children's Clinic
South 400 East, Washington Terrace, Weber County, Utah, 84408, United States
SUITE A
WASHINGTON TERRACE, UT 84405
Phone: (801) 475-7007
Fax: (801) 475-0703
Type: Location
5285 S 400 E STE A
WASHINGTON TERRACE, UT 844057194
Phone: (801) 334-0048
Fax: (833) 428-8406
Type: Location
2240, Adams Avenue, 25th Street, Ogden, Weber County, Utah, 84401, United States
OGDEN, UT 844011511
Phone: (801) 393-5355
Fax: (801) 394-4609
Type: Mailing
NPPES updates history
No NPPES updates recorded for this provider.
Prescription Activity
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Open Payments (CMS)
No Open Payments data available for this provider.
This can happen when there are no reportable CMS Open Payments records.
Medicare Enrollment & Revalidation
Source: CMS public data · Not endorsed by CMS ·
Educational use only—not medical, billing, or legal advice.
PECOS enrollment status
Participating (accepts Medicare assignment)
Enrollment effective: 2008-06-25
PECOS data refreshed: 2026-05-27
Medicare revalidation (CMS due date list)
Past revalidation due date
Earliest CMS due date was 2025-11-30 (191 days ago).
Enrollment records
1
Earliest due date
2025-11-30
CMS data updated
2026-06-01
Revalidation progress
- Medicare enrolled
- On CMS revalidation list
- Due date assigned
- Revalidate in PECOS
CMS enrollment records
| Enrollment ID | Type | Specialty | State | Due date |
|---|---|---|---|---|
| O20080625000179 | O | Federally Qualified Health Center (Fqhc) | UT | 2025-11-30 |
What to do next
- Verify current status on the CMS Revalidation Lookup Tool immediately.
- Complete revalidation in PECOS or contact your Medicare Administrative Contractor (MAC).
- Overdue revalidation can lead to deactivation of Medicare billing privileges.
Prepare CMS-855 application → · Look up this NPI in PECOS → · Verify on CMS PECOS
Medicare Utilization (FFS)
Source: CMS public data · Not endorsed by CMS · Beneficiary counts under 11 are suppressed in source data ·
Educational use only—not medical, billing, or legal advice.
No Medicare fee-for-service utilization data available for this provider in our database.
Insurance plans in this area (ZIP 84405)
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