SOUTHRIDGE CLINIC PEDIATRICS
NPI 1518108166
Pediatrics in Riverton, UT

NPI Status: Active since March 11, 2009

Contact Information

3723 W 12600 S
STE 330
RIVERTON, UT
ZIP 84065
Phone: (801) 285-4543

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  • Organization
  • Pediatrics
  • CLIA Number: 46D2301785
  • CLIA Cert. Type: Physician Office
  • CLIA Exp. Date: 03-31-2028

About SOUTHRIDGE CLINIC PEDIATRICS

This page provides the complete NPI Profile along with additional information for Southridge Clinic Pediatrics, a pediatrician established in Riverton, Utah operating as a Pediatrics. The healthcare provider is registered in the NPI registry with number 1518108166 assigned on March 2009. The practitioner's primary taxonomy code is 208000000X with license number 5722009 (UT). The provider is registered as an organization and their NPI record was last updated 10 years ago. The organization operates as a Single Specialty Group with one or more individual practitioners, all of who practice with the same area of specialization. The provider's is doing business as Southridge Clinic Pediatrics. The authorized official of this NPI record is Dr. Linda C Leckman Md (Ceo Intermountain Medical Group)

NPI
1518108166
Provider Legal Name
IHC HEALTH SERVICES INC
Other Organization Name
SOUTHRIDGE CLINIC PEDIATRICS
Other Name Type
Doing Business As (3)
Entity Type
Organization
Location Address
3723 W 12600 S STE 330 RIVERTON, UT 84065
Location Phone
(801) 285-4543
Mailing Address
PO BOX 27128 SALT LAKE CITY, UT 84127
Mailing Phone
(801) 285-4543
Is Sole Proprietor?
No
Is Organization Subpart?
No
Enumeration Date
03-11-2009
Last Update Date
03-15-2016
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A pediatrician like Southridge Clinic Pediatrics is a physician who has completed a pediatric residency and is board-certified or board-eligible in a pediatric specialty. Pediatric care providers are trained to care for newborns, infants, children and adolescents. A pediatrician could perform physical exams, manage vaccinations, monitor development milestones, diagnose illnesses, infections, injuries or other health problems, etc.

Location Map

Specialty - Primary Taxonomy

The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.

Classification

Pediatrics

Taxonomy Code
208000000X
Type
Allopathic & Osteopathic Physicians
License No.
5722009
License State
UT
Taxonomy Description
A pediatrician is concerned with the physical, emotional and social health of children from birth to young adulthood. Care encompasses a broad spectrum of health services ranging from preventive healthcare to the diagnosis and treatment of acute and chronic diseases. A pediatrician deals with biological, social and environmental influences on the developing child, and with the impact of disease and dysfunction on development.

Group Taxonomy 193400000X SINGLE SPECIALTY GROUP

This provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.

Insurance Plans Accepted

According to publicly available information the provider might be accepting the following health plans from these health insurance companies:

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

Specific plan information not avaialable, please contact the provider to verify if your insurance plan is accepted.

*Please verify directly with this provider to make sure your insurance plan is currently accepted.

Authorized Official

The authorized official is the designated individual with the legal authority to make changes to the provider’s official NPI record. For organizations, the authorized official must be a general partner, chairman of the board, CEO, CFO or a direct owner holding at least a 5 percent stake in the medical organization.

Authorized Official Name

DR. LINDA C LECKMAN MD

Authorized Official Title
CEO INTERMOUNTAIN MEDICAL GROUP
Authorized Official Phone
(801) 442-3974

Additional Identifiers

The NPI Enumerator encourages providers to submit additional identifiers with their NPI application although the submission of this information is optional. The additional identifier(s) section includes other numbers or codes currently or formerly used as an identifier for the provider by other public healthcare entities. The identifiers may include UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers.

Identifier Type / Code Identifier State Identifier Issuer
000055456MEDICARE UPIN (02)UT 

CLIA Information

The Clinical Laboratory Improvement Amendments (CLIA) of 1988 applies to facilities or sites that test human specimens for health assessment or to diagnose, prevent, or treat disease. The CLIA Program sets standards for clinical laboratory testing and issues certificates. The NPI / CLIA crosswalk information for this NPI number is:

CLIA Number
46D2301785
Facility Type
Physician Office
Certificate Effective Date
April 01, 2026
Certificate Expiration Date
March 31, 2028
Laboratory Director
JAKE S. FREEMAN
Certificate Type
Certificate for Provider-Performed Microscopy Procedures (PPMP)
Certificate Type Description
This CLIA certificate is issued to Southridge Clinic Pediatrics in which a physician, midlevel practitioner or dentist that performs specific microscopy procedures during the course of a patient's visit. A limited list of provider-performed microscopy procedures is included under this certificate type, which are categorized as moderate complexity testing.

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NPI NPI Number Validation

How NPI Validation Works

The NPI validation process uses the ISO-standard Luhn algorithm, a mathematical "handshake", to ensure that a provider's 10-digit ID is authentic and free of common typing errors.

To verify the NPI 1518108166, we treat the final digit (6) as the Check Digit—the target answer we need to reach. The process begins by taking the first nine digits and adding a constant value of 24, which accounts for the "80840" prefix required for all U.S. health identifiers. We then double every other digit starting from the right and sum the individual digits of those results together. For this specific NPI, that total comes to 54. The final step is to find the difference between that total and the next multiple of ten (60 - 54 = 6).

Digit-by-digit view

Use the first nine digits for the calculation. Starting from the right, double every other digit. The last digit is the check digit and is not part of the calculation.

Pos 1
1
Doubled → 2
Pos 2
5
Unchanged
Pos 3
1
Doubled → 2
Pos 4
8
Unchanged
Pos 5
1
Doubled → 2
Pos 6
0
Unchanged
Pos 7
8
Doubled → 16 → 1 + 6
Pos 8
1
Unchanged
Pos 9
6
Doubled → 12 → 1 + 2
Check
6
Target digit
Regular digit Doubled digit Check digit

Step 1: Double every other digit from the right

Starting with the rightmost digit of the first nine digits, double every other value. If doubling creates a two-digit number, add those digits together.

1 → 2 1 → 2 1 → 2 8 → 16 → 7 6 → 12 → 3

Step 2: Add all digits plus the NPI constant

Add the transformed values, the unchanged digits, and the constant 24.

2 + 5 + 2 + 8 + 2 + 0 + 1 + 6 + 1 + 1 + 2 + 24 = 54

Step 3: Find the amount needed to reach the next multiple of 10

The next multiple of ten after 54 is 60. The difference is the calculated check digit.

60 - 54 = 6
This NPI is valid
The calculated check digit is 6, which matches the last digit of 1518108166.

Other Providers at the Same Location


The following 20 providers are registered at the same or a nearby location.

Obstetrics & Gynecology
3723 W 12600 S, SUITE 360
RIVERTON, UT 84065
Pediatrics
3723 W 12600 S, SUITE 450
RIVERTON, UT 84065
Pediatrics
3723 W 12600 S, SUITE 450
RIVERTON, UT 84065
Internal Medicine
3723 W 12600 S, SUITE 270
RIVERTON, UT 84065
Pediatrics
3723 W 12600 S, SUITE 450
RIVERTON, UT 84065
Pediatrics
3723 W 12600 S, #150
RIVERTON, UT 84065
Emergency Medicine
3723 W 12600 S, #150
RIVERTON, UT 84065
Dermatology
3723 W 12600 S, SUITE 270
RIVERTON, UT 84065
Orthopaedic Surgery
3723 W 12600 S, #460
RIVERTON, UT 84065
Clinic/Center (Sleep Disorder Diagnostic)
3723 W 12600 S, STE 480
RIVERTON, UT 84065
Specialist/Technologist (Athletic Trainer)
3723 W 12600 S
RIVERTON, UT 84065
Internal Medicine (Sleep Medicine)
3723 W 12600 S, STE 480
RIVERTON, UT 84065
Surgery
3723 W 12600 S, SUITE 270
RIVERTON, UT 84065
Otolaryngology
3723 W 12600 S, SUITE 270B
RIVERTON, UT 84065
Pediatrics
3723 W 12600 S, STE 450
RIVERTON, UT 84065
Internal Medicine (Gastroenterology)
3723 W 12600 S, SUITE 270
RIVERTON, UT 84065
Internal Medicine (Cardiovascular Disease)
3723 W 12600 S
RIVERTON, UT 84065
Allergy & Immunology
3723 W 12600 S, SUITE 270
RIVERTON, UT 84065
Nurse Practitioner (Family)
3723 W 12600 S
RIVERTON, UT 84065
Internal Medicine
3723 W 12600 S, STE 430
RIVERTON, UT 84065

Frequently Asked Questions

The NPI number assigned to this healthcare provider is 1518108166, enumerated as an "organization" on March 11, 2009.

The provider is located at 3723 W 12600 S STE 330 RIVERTON, UT 84065 and the phone number is (801) 285-4543.

Pediatrics with taxonomy code 208000000X.

The provider might be accepting Accepts: Medicare and Medicaid. Please consult your insurance carrier or call the provider to verify.