Individual provider Active NPI

Stacie Winterton

  • Case Manager/Care Coordinator
  • Salt Lake City, UT
National Provider Identifier
1700243987
Registry record updated Sep 4, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Case Manager/Care CoordinatorTaxonomy code 171M00000X
Practice address
4460 S Highland Dr Ste 210
Salt Lake City, UT 84124
Phone
(888) 949-4864
NPI assigned
Jan 19, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 4, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X 215792326 UT
Case Manager/Care Coordinator 171M00000X Primary

Addresses

Primary practice location

4460 S Highland Dr Ste 210
Salt Lake City, UT 84124

Mailing address

4460 S Highland Dr Ste 210
Salt Lake City, UT 84124-3550
Phone (888) 949-4864

Other practice location 1

13046 S 2830 W
Riverton, UT 84065-6377
Phone (928) 581-6533

Other practice location 2

13046 S 2830 W
Riverton, UT 84065-6377
Phone (928) 581-6533

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
215792326UTMDBehavioral Analyst

NPI Registry JSON

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

{
    "created_epoch": "1453161600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1567555200000",
    "number": "1700243987",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841243550",
            "telephone_number": "888-949-4864"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4460 S HIGHLAND DR STE 210",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84124",
            "telephone_number": "888-949-4864"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "13046 S 2830 W",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840656377",
            "country_code": "US",
            "telephone_number": "928-581-6533",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "13046 S 2830 W",
            "address_purpose": "LOCATION",
            "city": "Riverton",
            "state": "UT",
            "postal_code": "840656377",
            "country_code": "US",
            "telephone_number": "928-581-6533",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WINTERTON",
        "first_name": "STACIE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-19",
        "last_updated": "2019-09-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": "UT",
            "license": "215792326",
            "primary": false
        },
        {
            "code": "171M00000X",
            "taxonomy_group": "",
            "desc": "Case Manager/Care Coordinator",
            "state": null,
            "license": null,
            "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 4, 2019; 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.