Organization Active NPI

Rocky Mountain Care - Palliative Care LLC

  • Hospice and Palliative Medicine (Internal Medicine) Physician
  • Woods Cross, UT
National Provider Identifier
1386224814
Registry record updated Feb 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Hospice and Palliative Medicine (Internal Medicine) PhysicianTaxonomy code 207RH0002X
Legal business name
ROCKY MOUNTAIN CARE - PALLIATIVE CARE LLC
Practice address
598 W 900 S Ste 105
Woods Cross, UT 84010-8329
Phone
(801) 693-2380
Fax
(801) 693-2379
NPI assigned
Apr 9, 2021
Last updated
Feb 18, 2025By the provider in NPPES
Organization subpart
Yes
Parent organization
SENIOR HEALTH LLCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Feb 18, 2025

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

Authorized official

Name
Edward Bangerter
Title
Authorized Official
Phone
(801) 397-4101

Specialties & licenses 4

Specialty (taxonomy)CodeLicenseStatePrimary
Geriatric Medicine (Family Medicine) Physician 207QG0300X
Internal Medicine Physician 207R00000X
Family Nurse Practitioner 363LF0000X
Hospice and Palliative Medicine (Internal Medicine) Physician 207RH0002X Primary

Addresses

Primary practice location

598 W 900 S Ste 105
Woods Cross, UT 84010-8329

Mailing address

598 W 900 S Ste 105
Woods Cross, UT 84010-8329
Phone (801) 693-2380

Other practice location 1

2100 Northwest Blvd Ste 120
Coeur D Alene, ID 83814-5047
Phone (208) 505-4060

Other practice location 2

2929 W Navigator Dr Ste 310
Meridian, ID 83642-8297
Phone (208) 505-4060

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT, ID2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20240702004082 UT Part B Supplier - Clinic/Group Practice 2961946868 Receives reassigned benefits from 6 practitioners
Practice locations: Woods Cross, UT
O20240712003736 ID Part B Supplier - Clinic/Group Practice 2961946868 Receives reassigned benefits from 4 practitioners
Practice locations: Coeur D Alene, ID

Laboratory certificates & supplier records

Derived by NPIMap

These CMS records do not include an NPI. They are shown because their name and street address match this provider’s.

CLIA laboratory certificates

CLIA numberLaboratoryCertificateExpires
46D2337075Rocky Mountain Care - Palliative Care598 W 900 S, Ste 105, Woods Cross, UT 84010Certificate of waiverJan 14, 2028

National Provider Directory

National Provider Directory
Part of
Senior Health LLC

Member of 1

Organizations this organization is a member of, according to the National Provider Directory.

Locations

2929 W Navigator Dr
Ste 310
Meridian, ID 83642
Phone (208) 506-7200

576 W 900 S
Ste 103
Woods Cross, UT 84010
Phone (801) 693-2380

576 W 900 S
Ste 104
Woods Cross, UT 84010

Ownership & related parties

Parent organization (reported in NPPES) 1

This organization reports itself as a subpart in NPPES; the parent’s legal name matches this organization in the same state.

Practitioners & affiliated clinicians

Practitioners 10

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.

NPI Registry JSON

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

{
    "created_epoch": "1617926400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739836800000",
    "number": "1386224814",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "598 W 900 S STE 105",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840108329",
            "telephone_number": "801-693-2380",
            "fax_number": "801-693-2379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "598 W 900 S STE 105",
            "city": "WOODS CROSS",
            "state": "UT",
            "postal_code": "840108329",
            "telephone_number": "801-693-2380",
            "fax_number": "801-693-2379"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2100 Northwest Blvd Ste 120",
            "address_purpose": "LOCATION",
            "city": "Coeur D Alene",
            "state": "ID",
            "postal_code": "838145047",
            "country_code": "US",
            "telephone_number": "208-505-4060",
            "fax_number": "801-693-2399",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2929 W Navigator Dr Ste 310",
            "address_purpose": "LOCATION",
            "city": "Meridian",
            "state": "ID",
            "postal_code": "836428297",
            "country_code": "US",
            "telephone_number": "208-505-4060",
            "fax_number": "801-693-2379",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ROCKY MOUNTAIN CARE - PALLIATIVE CARE LLC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "SENIOR HEALTH LLC",
        "enumeration_date": "2021-04-09",
        "last_updated": "2025-02-18",
        "certification_date": "2025-02-18",
        "status": "A",
        "authorized_official_last_name": "BANGERTER",
        "authorized_official_first_name": "EDWARD",
        "authorized_official_title_or_position": "AUTHORIZED OFFICIAL",
        "authorized_official_telephone_number": "801-397-4101"
    },
    "taxonomies": [
        {
            "code": "207QG0300X",
            "taxonomy_group": "",
            "desc": "Family Medicine, Geriatric Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207R00000X",
            "taxonomy_group": "",
            "desc": "Internal Medicine",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "363LF0000X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Family",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "207RH0002X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Hospice and Palliative Medicine",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woods Cross, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 18, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.