Willow Creek Hospice of Utah, L.L.C.

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

Legal business name

WILLOW CREEK HOSPICE OF UTAH, L.L.C.

Practice address

5200 S Highland Dr
Suite 200
Holladay, UT 84117-7057

Phone

(801) 277-3298

Fax

(801) 277-3598

NPI assigned

Jan 15, 2009

Organization subpart

No

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

Authorized official

Name

Mr. Trace D. Osborne, C.P.A.

Title

Manager

Phone

(801) 272-3298

Specialties & licenses 1

Addresses

Other identifiers 1

Other names 1

• Pine Mountain Hospice Doing business as

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

{
    "created_epoch": "1231977600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392940800000",
    "number": "1306083159",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5200 S HIGHLAND DR",
            "address_2": "SUITE 200",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841177057",
            "telephone_number": "801-277-3298",
            "fax_number": "801-277-3598"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5200 S HIGHLAND DR",
            "address_2": "SUITE 200",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841177057",
            "telephone_number": "801-277-3298",
            "fax_number": "801-277-3598"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "WILLOW CREEK HOSPICE OF UTAH, L.L.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-01-15",
        "last_updated": "2014-02-21",
        "status": "A",
        "authorized_official_last_name": "OSBORNE",
        "authorized_official_first_name": "TRACE",
        "authorized_official_middle_name": "D.",
        "authorized_official_title_or_position": "MANAGER",
        "authorized_official_telephone_number": "801-272-3298",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "C.P.A."
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "272046420001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Pine Mountain Hospice",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sara White
• Brittni Amber Whitesides, RDN
• Abbey M Whiting, MPAS, PA-C
• Michelle Wilkinson, APRN
• Rebecca Jo Williams, CNM
• Kaitlyn Shyanne Wininger, LMT
• Tana Lee Winkler, LMT
• Women & Birth Care
• P Wade Wyatt, MD
• Zest for Life Counseling - Holladay

• Community Based Hospice Care Agency in Holladay, UT
• Providers in Holladay, 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 Feb 21, 2014; 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.