Caresource

Primary specialty

Home Health AgencyTaxonomy code 251E00000X

License

2006-HHA-912 Issued in UT

Legal business name

CARESOURCE

Practice address

750 Kearns Blvd. #200
Park City, UT 84060

Phone

(801) 266-7200

Fax

(801) 266-7004

NPI assigned

Apr 18, 2006

Last updated

Nov 14, 2016By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mrs. Shawntel Elizabeth Tanner, MA

Title

Ceo/Administrator

Phone

(801) 266-7200

Specialties & licenses 1

Addresses

Other names 1

• CareSource Home Health and Hospice Other name

Tax ID family

Caresource3 organizations share this tax ID, including this one

Other organizations with this tax ID 2

Organizations that report the same tax identification number in the National Provider Directory.

• Caresource

  • Hospice and Palliative Medicine (Family Medicine) Physician
  • Salt Lake City, UT
  • NPI 1124242128
  NPD tax ID
• Caresource

  dba CareSource Rehab and Supportive Care

  • Skilled Nursing Facility
  • Salt Lake City, UT
  • NPI 1316490402
  NPD tax ID

Locations

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

{
    "created_epoch": "1145318400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1902861693",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 680839",
            "address_2": "750 KEARNS BLVD. #200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84068",
            "telephone_number": "801-266-7200",
            "fax_number": "801-266-7004"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "750 KEARNS BLVD. #200",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "84060",
            "telephone_number": "801-266-7200",
            "fax_number": "801-266-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESOURCE",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-04-18",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "SHAWNTEL",
        "authorized_official_middle_name": "ELIZABETH",
        "authorized_official_title_or_position": "CEO/ADMINISTRATOR",
        "authorized_official_telephone_number": "801-266-7200",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA"
    },
    "taxonomies": [
        {
            "code": "251E00000X",
            "taxonomy_group": "",
            "desc": "Home Health",
            "state": "UT",
            "license": "2006-HHA-912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareSource Home Health and Hospice",
            "code": "5",
            "type": "Other Name"
        }
    ]
}

• Cody Michael Calderwood
• Michael D Call, CRNA
• Annie Jane Xiao Xiao Cannon, PA-C
• Care Planning Institute, Inc
• Care Planning Institute, Inc
• Caresource Charitable Association (CareSource Hospice at Home)
• Caresource L L C
• Karin Carestia
• Adam Haynes Carewe, MD
• Stephanie Castle, OD

• Home Health Agency in Park City, UT
• Providers in Park City, UT by specialty
• Home Health Agency in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 14, 2016; 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.