Active NPI
Laura Bunting, RN
- Registered Nurse
- Provo, UT
National Provider Identifier
1104253012
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Registered Nurse
- License
- 7672149-3102
- Practice address
- 151 S University Ave
Ste 1610
Provo, UT 84601-4427 - Phone
- (801) 851-7052
- Fax
- (801) 851-7063
- NPI assigned
- Oct 9, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Registered Nurse | 163W00000X | 7672149-3102 | UT | Primary |
Addresses
Primary practice location
151 S University Ave
Ste 1610
Provo, UT 84601-4427
Mailing address
151 S University Ave
Ste 1610
Provo, UT 84601-4427
Phone (801) 851-7052
Other identifiers 4
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1225109063 | Medicaid | UT | |
| 998877660009 | Medicaid | UT | |
| PR00489 | Medicaid | UT | |
| 1891865010 | Medicaid | UT |
Other names 1
- Camille Kaouk
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Registered Nurse
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7672149-3102 | UT | MD | Registered Nurse |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1381276800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1381276800000",
"number": "1104253012",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "151 S UNIVERSITY AVE",
"address_2": "STE 1610",
"city": "PROVO",
"state": "UT",
"postal_code": "846014427",
"telephone_number": "801-851-7052",
"fax_number": "801-851-7063"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "151 S UNIVERSITY AVE",
"address_2": "STE 1610",
"city": "PROVO",
"state": "UT",
"postal_code": "846014427",
"telephone_number": "801-851-7052",
"fax_number": "801-851-7063"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BUNTING",
"first_name": "LAURA",
"credential": "RN",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-10-09",
"last_updated": "2013-10-09",
"status": "A"
},
"taxonomies": [
{
"code": "163W00000X",
"taxonomy_group": "",
"desc": "Registered Nurse",
"state": "UT",
"license": "7672149-3102",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1225109063",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "998877660009",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "PR00489",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "1891865010",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "CAMILLE",
"last_name": "KAOUK",
"code": "2",
"type": "Professional Name"
}
]
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 9, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.