Individual provider Active NPI

Angela Carrascohinojosa

  • Case Management Registered Nurse
  • Salt Lake City, UT
National Provider Identifier
1124609433
Registry record updated Apr 19, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Management Registered NurseTaxonomy code 163WC0400X
License
11101647-3102 Issued in UT
Practice address
857 E 200 S
Salt Lake City, UT 84102-2317
Phone
(801) 487-3276
Fax
(801) 467-3725
NPI assigned
Apr 19, 2021
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 19, 2021

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Case Management Registered Nurse 163WC0400X 11101647-3102 UT Primary

Addresses

Primary practice location

857 E 200 S
Salt Lake City, UT 84102-2317

Mailing address

857 E 200 S
Salt Lake City, UT 84102-2317
Phone (801) 487-3276

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

State licenses

LicenseStateTypeSpecialty
11101647-3102UTMDCase Management Registered Nurse

NPI Registry JSON

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

{
    "created_epoch": "1618790400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1618790400000",
    "number": "1124609433",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022317",
            "telephone_number": "801-487-3276",
            "fax_number": "801-467-3725"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022317",
            "telephone_number": "801-487-3276",
            "fax_number": "801-467-3725"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CARRASCOHINOJOSA",
        "first_name": "ANGELA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2021-04-19",
        "last_updated": "2021-04-19",
        "certification_date": "2021-04-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WC0400X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Case Management",
            "state": "UT",
            "license": "11101647-3102",
            "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 Apr 19, 2021; 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.