Individual provider Active NPI

Lesli Shooter, NBC-HWC

  • Health Educator
  • Salt Lake City, UT
National Provider Identifier
1669209524
Registry record updated Sep 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Health EducatorTaxonomy code 174H00000X
License
A-3979608 Issued in UT
Practice address
227 E 4TH Ave
Salt Lake City, UT 84103-2484
Phone
(801) 875-3745
NPI assigned
Sep 16, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 16, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Health EducatorGroup: 193200000X MULTI-SPECIALTY GROUP 174H00000X A-3979608 UT Primary

Addresses

Primary practice location

227 E 4TH Ave
Salt Lake City, UT 84103-2484

Mailing address

227 E 4TH Ave
Salt Lake City, UT 84103-2484
Phone (801) 875-3745

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
A-3979608UTMDHealth Educator

NPI Registry JSON

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

{
    "created_epoch": "1726444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1726444800000",
    "number": "1669209524",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "227 E 4TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032484",
            "telephone_number": "801-875-3745"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "227 E 4TH AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032484",
            "telephone_number": "801-875-3745"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOOTER",
        "first_name": "LESLI",
        "credential": "NBC-HWC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-09-16",
        "last_updated": "2024-09-16",
        "certification_date": "2024-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": "UT",
            "license": "A-3979608",
            "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 Sep 16, 2024; 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.