Carol A Leatherman, PA

Primary specialty

Physician AssistantTaxonomy code 363A00000X

License

9454093-1206 Issued in UT

Practice address

750 Round Valley Dr
Suite 200
Park City, UT 84060-7548

Phone

(435) 658-7246

NPI assigned

May 4, 2006

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: Yes
• Power mobility devices: Yes
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Physician Assistant

Education

Other, 2005

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

Hospital & facility affiliations

• Park City Hospital Hospital, Park City, UT, CCN 460057
• Intermountain Health Heber Valley Hospital Hospital, Heber City, UT, CCN 461307

Medicare enrollment (NPD)

Enrolled

Credentials

Physician Assistant

State licenses

Practice roles

Locations

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.

• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Sandy, UT
  • NPI 1942325154
  Medicare reassignment Care Compare group
• Ihc Health Services Inc

  • Family Medicine Physician
  • Salt Lake City, UT
  • NPI 1003219486
  NPD
• Ihc Health Services, Inc.

  • Psychiatry Physician
  • St George, UT
  • NPI 1023843844
  NPD
• Ihc Health Services Inc

  • Multi-Specialty Clinic/Center
  • Orem, UT
  • NPI 1588601124
  NPD (past)
• Urology Center of Northeastern Ky

  • Urology Physician
  • Ashland, KY
  • NPI 1407898877
  NPD (past)

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

• Ihc Health Services Inc

  • Critical Access Hospital
  • Heber City, UT
  • NPI 1316055205
  Care Compare affiliation
• Ihc Health Services Inc

  • General Acute Care Hospital
  • Park City, UT
  • NPI 1851530984
  Care Compare affiliation

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

{
    "created_epoch": "1146700800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1490745600000",
    "number": "1700834686",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 27128",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841270128",
            "telephone_number": "435-658-7246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 ROUND VALLEY DR",
            "address_2": "SUITE 200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840607548",
            "telephone_number": "435-658-7246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LEATHERMAN",
        "first_name": "CAROL",
        "middle_name": "A",
        "credential": "PA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-05-04",
        "last_updated": "2017-03-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363AS0400X",
            "taxonomy_group": "",
            "desc": "Physician Assistant, Surgical",
            "state": "KY",
            "license": "PA920",
            "primary": false
        },
        {
            "code": "363A00000X",
            "taxonomy_group": "",
            "desc": "Physician Assistant",
            "state": "UT",
            "license": "9454093-1206",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Darrell Larry, OTR
• Ciara Pearle Larson, CSW
• Elaine A Larson, DPT
• Katherine Rebecca Lavender, M.D.
• Susan Lawrence, RPH
• Morgan Leigh Leaventon
• Sandra Jolene Lehman
• Mairi Gael Leining, MD
• Molly Lent, CSW
• Ronald Herbert Lepley, FNP-C

• Physician Assistant in Park City, UT
• Providers in Park City, UT by specialty
• Physician Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 29, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• 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.