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AFFINITY HEALTHCARE, INC.
NPI 1144928854
Family Medicine in Logan, UT

Active since February 21, 2023CLIA 46D2279100 · Waiver
93 EAST 200 SOUTH, SUITE 210-B, LOGAN, UT 84321(435) 276-0888(833) 471-4536 Get Directions Write a Review

NPPES record last updated: December 29, 2025. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Dec 29, 2025, Nov 15, 2023, May 22, 2023 and 1 more (4 updates tracked since 2023).

About Affinity Healthcare, Inc. NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

AFFINITY HEALTHCARE, INC. (NPI 1144928854) is a healthcare organization registered as a family medicine in Logan, Utah and active in the NPI registry since February 2023. The organization holds a CLIA Waiver certificate valid through March 28, 2027 and lists Laval B Jensen, Ceo, as its authorized official.

NPPES Registry Identity

NPI1144928854
Entity TypeOrganization
Primary Taxonomy207Q00000X
Legal Business NameAFFINITY HEALTHCARE, INC.
Location Address93 EAST 200 SOUTH, SUITE 210-BLogan, UT 84321
Mailing Address2380 N 400 E Ste BNorth Logan, UT 84341-1756 · (435) 276-0888
Phone(435) 276-0888
Fax(833) 471-4536
Organization SubpartNo
Authorized OfficialLaval B JensenCeo · (435) 276-0888
Enumeration DateFebruary 21, 2023
Last NPPES UpdateDecember 29, 20254 updates tracked since enumeration
NPPES CertifiedDecember 29, 2025
✔ NPI 1144928854 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyFamily MedicineAllopathic & Osteopathic Physicians
Taxonomy Code207Q00000X
Definition
Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity.
93 EAST 200 SOUTH, Logan, UT 84321
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Other Identifiers 2

Medicaid3006721UT
Medicaid4201995UT

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Molina Healthcare.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)

Affinity Healthcare, Inc. is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 1 clinician reassigns Medicare billing to Affinity Healthcare, Inc., which bills Medicare for the services this clinician delivers.

Clinician (1)

Glenn Robertson, MD
Family Practice
NPI 1144281122
2380 N 400 E STE A
North Logan, UT 84341
(435) 554-3240
✔ PECOS✔ Accepts Medicare2.4 mi

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 of Waiver 46D2279100

Affinity Healthcare Inc · Logan, UT
Active · expires Mar 28, 2027
CLIA Number46D2279100
Laboratory TypePhysician Office
Certificate Effective DateMarch 29, 2025
Certificate Expiration DateMarch 28, 2027
Laboratory DirectorDaniela P. Fawson
Laboratory Phone(435) 276-0888
Laboratory LocationAffinity Healthcare Inc93 East 200 South, Suite 210-B, Logan, UT 84321
CLIA data matches this NPI record on: Address Name Phone
This certificate is issued to a laboratory to perform only waived tests.

Frequently 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 Affinity Healthcare, Inc.'s NPI number?

The NPI number for Affinity Healthcare, Inc. is 1144928854. It was assigned to this organization in the NPPES registry on February 21, 2023.

Where is Affinity Healthcare, Inc. located?

Affinity Healthcare, Inc. is located at 93 East 200 South Suite 210-B, Logan, UT 84321. The listed phone number is (435) 276-0888.

What is Affinity Healthcare, Inc.'s specialty?

The primary specialty registered for this NPI is Family Medicine with taxonomy code 207Q00000X.

Is Affinity Healthcare, Inc. enrolled in Medicare?

Yes. Affinity Healthcare, Inc. is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Affinity Healthcare, Inc.?

According to the CMS Revalidation Reassignment List (October 2026 release), 1 clinician (Family Practice) reassigns their Medicare billing to Affinity Healthcare, 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. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Does Affinity Healthcare, Inc. hold a CLIA laboratory certificate?

Yes. A Certificate of Waiver (number 46D2279100) is associated with this NPI, valid through March 28, 2027. CLIA certificates authorize laboratory testing under the federal Clinical Laboratory Improvement Amendments program.

What insurance does Affinity Healthcare, Inc. accept?

Health plans from Molina Healthcare list Affinity Healthcare, 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 Affinity Healthcare, Inc. was last updated on December 29, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months 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.