Caresource LLC

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2006-HOSPICE-30731 Issued in UT

Legal business name

CARESOURCE LLC

Practice address

1624 E 4500 S
Salt Lake City, UT 84117-4212

Phone

(801) 266-7200

Fax

(801) 266-7004

NPI assigned

Apr 12, 2007

Last updated

Mar 16, 2012By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shawntel Tanner, MA

Title

Administrator

Phone

(801) 266-7200

Specialties & licenses 1

Addresses

Other names 1

• CareSource Hospice Other name

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina Coccimiglio, DNP, AGPCNP - BC

  • Adult Health Nurse Practitioner
  • Henderson, NV
  • NPI 1659751451
  NPD (past)

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331856000000",
    "number": "1235353236",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1624 E 4500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174212",
            "telephone_number": "801-266-7200",
            "fax_number": "801-266-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1624 E 4500 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841174212",
            "telephone_number": "801-266-7200",
            "fax_number": "801-266-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESOURCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-12",
        "last_updated": "2012-03-16",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "SHAWNTEL",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-266-7200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "UT",
            "license": "2006-HOSPICE-30731",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareSource Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Caregiver Support Network, Inc (Caregiver Support Network Hospice)
• Carepoint Health, LLC
• Carepoint Inpatient Blue Sky Neurology Utah, PLLC
• Caresource
• Caresource (CareSource Rehab and Supportive Care)
• Carethera
• Adrienne L Carey
• Jacob Nathaniel Carey
• John C. Carey
• Santiago Moises Carhuatanta

• Community Based Hospice Care Agency in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Community Based Hospice Care Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 16, 2012; 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.