72ND STREET MEDICAL CLINIC
NPI 1073611364
Clinic/Center - Federally Qualified Health Center (FQHC) in Midvale, UT
About 72nd Street Medical Clinic NPPES
Official registry information on file with the National Plan and Provider Enumeration System.
72ND STREET MEDICAL CLINIC (NPI 1073611364) is a healthcare organization registered as a federally qualified health center (fqhc) in Midvale, Utah and active in the NPI registry since September 2006. The organization holds a CLIA Microscopy certificate valid through February 4, 2027 and lists Jennifer Lyn Thomas, Executive Director, as its authorized official.
NPPES Registry Identity
Specialties & Licenses 7
Other Names 1
Other Identifiers 1
Group Practice 1
Accepted Insurance
Medicare Participation & PECOS CMS
Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.
Medicare Enrollment Status
Enrolled in Medicare (PECOS)
72nd Street Medical Clinic is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).
Clinicians Billing Medicare Through This Organization
59Medicare enrollment records show 59 clinicians reassign Medicare billing to 72nd Street Medical Clinic, which bills Medicare for the services they deliver. Of these, 2 practice at this address and 39 within 10 miles. Listed here are the 20 practicing nearest to this location.
Clinicians by Medicare Specialty 9
Nearest to this location (20)
See all 59Midvale, UT 84047
Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
CLIA Laboratory Certificates CMS CLIA
Laboratory certificates issued under the Clinical Laboratory Improvement Amendments (CLIA) program, which sets federal quality standards for human laboratory testing in the United States. There is no official CMS crosswalk between CLIA and NPI numbers; these certificates are associated with this NPI by matching facility names, locations and phone numbers in the CMS CLIA registry.
Certificate for Provider-Performed Microscopy Procedures (PPMP) 46D0524383
Community Health Centers, Inc · West Valley City, UTFrequently Asked Questions NPPES & CMS
Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.
What is Community Health Centers, Inc.'s NPI number?
The NPI number for Community Health Centers, Inc. is 1073611364. It was assigned to this organization in the NPPES registry on September 20, 2006. The provider is doing business as 72nd Street Medical Clinic.
Where is Community Health Centers, Inc. located?
Community Health Centers, Inc. is located at 220 W 7200 S Suite A, Midvale, UT 84047. The listed phone number is (801) 566-5494.
What is Community Health Centers, Inc.'s specialty?
The primary specialty registered for this NPI is Clinic/Center, specializing in Federally Qualified Health Center (FQHC), with taxonomy code 261QF0400X.
Is Community Health Centers, Inc. enrolled in Medicare?
Yes. Community Health Centers, Inc. is registered in the Medicare PECOS enrollment system.
How many clinicians bill Medicare through Community Health Centers, Inc.?
According to the CMS Revalidation Reassignment List (October 2026 release), 59 clinicians in 9 Medicare specialties reassign their Medicare billing to Community Health Centers, Inc.. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Family Practice (36), Nurse Practitioner (7) and Dentist (4). Of these, 2 practice at this address and 39 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.
Does Community Health Centers, Inc. hold a CLIA laboratory certificate?
Yes. A Certificate for Provider-Performed Microscopy Procedures (PPMP) (number 46D0524383) is associated with this NPI, valid through February 4, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.
What insurance does Community Health Centers, Inc. accept?
Health plans from Molina Healthcare and University of Utah Health Plans list Community Health Centers, Inc. as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.
When was this NPI record last updated?
The NPPES record for Community Health Centers, Inc. was last updated on October 30, 2023. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 2 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.
# 72nd Street Medical Clinic · NPI 1073611364
Federally Qualified Health Center (FQHC) organization in Midvale, Utah. Organization record, active in the CMS NPPES registry since September 20, 2006.
## Identity
- **NPI:** 1073611364 (Entity type: Organization)
- **Enumerated:** September 20, 2006
- **Primary specialty:** Clinic/Center - Federally Qualified Health Center (FQHC) · taxonomy 261QF0400X
- **Legal business name:** Community Health Centers, Inc.
- **Organization subpart:** No
- **Authorized official:** Jennifer Thomas, EXECUTIVE DIRECTOR
## Practice location
- **Address:** 220 W 7200 S, SUITE A, Midvale, UT 84047-1043
- **Phone:** (801) 566-5494 · **Fax:** (877) 497-4661
## Medicare
- **Medicare:** Enrolled in Medicare (PECOS)
- **Clinicians billing through this organization:** 59 clinicians in 9 Medicare specialties reassign Medicare billing to this organization (form CMS-855R); largest: Family Practice (36), Nurse Practitioner (7), Dentist (4); 2 practice at this address and 39 within 10 miles; [full list](https://npiprofile.com/npi/1073611364/clinicians) · CMS Revalidation Reassignment List, October 2026 release
## Record status
- **NPPES last updated:** October 30, 2023
- **Other identifiers:** Medicaid 1073611364 (UT)
- **CLIA laboratory certificates:** 1 on file
---
Source: [NPI Profile](https://npiprofile.com/npi/1073611364) · Data from the CMS NPPES public registry.