Individual provider Active NPI

Timothy Robert Hunter, MS, RN, CCM, CSPO

  • Case Management Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1104665546
Registry record updated May 24, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
13014860-3102 Issued in UT
Practice address
1030 S 400 W Unit 503
Salt Lake City, UT 84101-3250
Phone
(385) 201-5802
NPI assigned
May 24, 2024
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 24, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Administrator Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WA2000X 13014860-3102 UT
Case Management Registered NurseGroup: 193200000X MULTI-SPECIALTY GROUP 163WC0400X 13014860-3102 UT Primary

Addresses

Primary practice location

1030 S 400 W Unit 503
Salt Lake City, UT 84101-3250

Mailing address

1030 S 400 W Unit 503
Salt Lake City, UT 84101-3250
Phone (385) 201-5802

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
Master of Science, Registered Nurse

State licenses

LicenseStateTypeSpecialty
13014860-3102UTMDAdministrator Registered Nurse

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1716508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1716508800000",
    "number": "1104665546",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S 400 W UNIT 503",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013250",
            "telephone_number": "385-201-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S 400 W UNIT 503",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841013250",
            "telephone_number": "385-201-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUNTER",
        "first_name": "TIMOTHY",
        "middle_name": "ROBERT",
        "credential": "MS, RN, CCM, CSPO",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2024-05-24",
        "last_updated": "2024-05-24",
        "certification_date": "2024-05-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WA2000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Administrator",
            "state": "UT",
            "license": "13014860-3102",
            "primary": false
        },
        {
            "code": "163WC0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Registered Nurse, Case Management",
            "state": "UT",
            "license": "13014860-3102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.