Active NPI
Leslie Van Goldtooth
- Case Manager/Care Coordinator
- Moab, UT
National Provider Identifier
1275908279
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Case Manager/Care Coordinator
- Practice address
- 198 E Center St
Moab, UT 84532-2430 - Phone
- (435) 259-6131
- Fax
- (435) 259-5369
- NPI assigned
- Dec 2, 2015
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Case Manager/Care Coordinator | 171M00000X | Primary |
Addresses
Primary practice location
198 E Center St
Moab, UT 84532-2430
Mailing address
PO Box 867
Price, UT 84501-0867
Phone (435) 637-7200
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
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Four Corners Community Behavioral Health Inc | Past | Accepting new patients | |
| Four Corners Community Behavioral Health, Inc. | Past | Accepting new patients |
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.
-
- Methadone Clinic
- Price, UT
- NPI 1164048492
-
- Community/Behavioral Health Agency
- Price, UT
- NPI 1487715330
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1449014400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1449014400000",
"number": "1275908279",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 867",
"city": "PRICE",
"state": "UT",
"postal_code": "845010867",
"telephone_number": "435-637-7200",
"fax_number": "435-637-2377"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "198 E CENTER ST",
"city": "MOAB",
"state": "UT",
"postal_code": "845322430",
"telephone_number": "435-259-6131",
"fax_number": "435-259-5369"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GOLDTOOTH",
"first_name": "LESLIE",
"middle_name": "VAN",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2015-12-02",
"last_updated": "2015-12-02",
"status": "A"
},
"taxonomies": [
{
"code": "171M00000X",
"taxonomy_group": "",
"desc": "Case Manager/Care Coordinator",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Moab, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.