Individual provider Active NPI

Carrie L Sloan, M.D.LLC

  • Specialist
  • Draper, UT
National Provider Identifier
1124034012
Registry record updated Jan 28, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
5666633-1205 Issued in UT
Practice address
96 E Kimballs LN Ste 202
Draper, UT 84020-5021
Phone
(801) 523-3053
Fax
(801) 523-3059
NPI assigned
Jul 31, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 28, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 5666633-1205 UT Primary

Addresses

Primary practice location

96 E Kimballs LN Ste 202
Draper, UT 84020-5021

Mailing address

PO Box 198546
Atlanta, GA 30384-8546

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address csloan5535@epicmtn.hcadirect.net

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: Yes
  • Power mobility devices: Yes
  • Hospice: Yes
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050319000025 UT Practitioner - Obstetrics/Gynecology 5597710913 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Obstetrics/Gynecology
Education
New York Medical College, 1996
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
St Mark'S Gynecology Oncology Care LLCGroup PAC ID 4486736279, 17 clinicians

Practice addresses (Care Compare)

1140 E 3900
Suite 400
Salt Lake City, UT 84124-1269
Phone (801) 268-6811

96 E Kimballs LN
Suite 202
Draper, UT 84020-5021
Phone (801) 523-3053

Hospital & facility affiliations

  • Lone Peak Hospital Hospital, Draper, UT, CCN 460060

Procedures performed for Medicare patients

ProcedureNumber of procedures
Removal of the uterus1-10

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
5666633-1205UTMDSpecialist

Practice roles (1 of 3)

OrganizationSpecialtyStatusNew patients
OB/GYN Associates. L.C. Specialist Past Accepting new patients

Networks

  • UT PPO D-SNP
  • UT PPO

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

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

{
    "created_epoch": "1154304000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1643328000000",
    "number": "1124034012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 198546",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303848546"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 E KIMBALLS LN STE 202",
            "city": "DRAPER",
            "state": "UT",
            "postal_code": "840205021",
            "telephone_number": "801-523-3053",
            "fax_number": "801-523-3059"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SLOAN",
        "first_name": "CARRIE",
        "middle_name": "L",
        "credential": "M.D.LLC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-07-31",
        "last_updated": "2022-01-28",
        "certification_date": "2020-11-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "5666633-1205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "csloan5535@epicmtn.hcadirect.net",
            "affiliation": "N",
            "address_1": "96 E Kimballs Ln Ste 202",
            "city": "Draper",
            "state": "UT",
            "country_code": "US",
            "postal_code": "840205021",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Draper, UT

Sources for this page

Verify at the official NPI Registry.