Intermountain Homecare Home Health Logan – Home Health Agency, NPI 1558436980

Intermountain Homecare Home Health Logan is a healthcare provider. based in Logan, Utah. specializing in Home Health Agency. The NPI Number for Intermountain Homecare Home Health Logan is 1558436980

Main info

Organization
Name
Intermountain Homecare Home Health Logan
NPI
1558436980
Phone
(435) 716-5477
Address
550 E 1400 N STE G
Authorized Official
MARK PROVAN VP-HOMECARE HOSPICE PALLIATIVE CARE
Enumeration Date
21 November 2006
Last Update Date
29 January 2025
Data current as of
19 May 2026

Profile Insights

NPPES metrics only — not quality of care.

Methodology
Experience53
Completeness80
Years active:19State licenses:0Digital endpointsUpdated within 12 months

Provider Addresses for Intermountain Homecare Home Health Logan

  • 550 E 1400 N STE G

    LOGAN, UT 843412450

    Phone: (435) 716-5477

    Type: Location

  • South Redwood Road, West Jordan, Salt Lake County, Utah, 84088, United States

    SOUTH JORDAN, UT 840957805

    Phone: (385) 887-6000

    Fax: (801) 442-0603

    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: 2004-12-17

PECOS data refreshed: 2026-05-27

Medicare revalidation (CMS due date list)

Due date not assigned yet

CMS is tracking this Medicare enrollment for revalidation, but has not published a due date.

Enrollment records

1

Earliest due date

Not assigned (TBD)

CMS data updated

2026-06-01

Revalidation progress

  1. Medicare enrolled
  2. On CMS revalidation list
  3. Due date assigned
  4. Revalidate in PECOS

CMS enrollment records

Enrollment IDTypeSpecialtyStateDue date
O20041217000146OHome Health AgencyUTTBD

What to do next

  • No action required while the due date shows TBD.
  • Check the CMS Revalidation Lookup Tool periodically — CMS updates the list about every 60 days.
  • Do not submit a revalidation application in PECOS until CMS publishes a concrete due date.

Verify on CMS Revalidation Lookup Tool

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 84341)

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Reviews

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Frequently asked questions

Is Intermountain Homecare Home Health Logan listed with a National Provider Identifier?
Yes — Intermountain Homecare Home Health Logan has NPI 1558436980 on file in the registry.
Is Intermountain Homecare Home Health Logan shown as active in public data?
Registry records indicate Intermountain Homecare Home Health Logan maintains an active NPI.
What kind of doctor is Intermountain Homecare Home Health Logan?
Intermountain Homecare Home Health Logan is associated with Home Health Agency in the directory — Clinical services aligned with this taxonomy classification.
What practice footprint exists for Intermountain Homecare Home Health Logan?
Travel planning: use Logan, Utah as the reference point for Intermountain Homecare Home Health Logan, then confirm.
When was this NPI issued?
Enumeration for Intermountain Homecare Home Health Logan is noted as November 21, 2006 where the registry provides it.

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