Caresource Charitable Association

Primary specialty

Community Based Hospice Care AgencyTaxonomy code 251G00000X

License

2016 Issued in UT

Legal business name

CARESOURCE CHARITABLE ASSOCIATION

Doing business as

CareSource Hospice at Home

Practice address

750 Kearns Blvd # 200
Park City, UT 84060-5137

Phone

(801) 266-7200

Fax

(801) 266-7004

NPI assigned

Sep 7, 2016

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

Shawntel Yates Tanner, MA, CHPCA, SSW, PHR

Title

Administrator

Phone

(801) 266-7200

Specialties & licenses 1

Addresses

Other names 1

• CareSource Hospice at Home Doing business as

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

{
    "created_epoch": "1473206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1479081600000",
    "number": "1932656923",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "750 KEARNS BLVD. #200",
            "address_2": "PO BOX 683593",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840683593",
            "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": "840605137",
            "telephone_number": "801-266-7200",
            "fax_number": "801-266-7004"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CARESOURCE CHARITABLE ASSOCIATION",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-09-07",
        "last_updated": "2016-11-14",
        "status": "A",
        "authorized_official_last_name": "TANNER",
        "authorized_official_first_name": "SHAWNTEL",
        "authorized_official_middle_name": "YATES",
        "authorized_official_title_or_position": "ADMINISTRATOR",
        "authorized_official_telephone_number": "801-266-7200",
        "authorized_official_credential": "MA, CHPCA, SSW, PHR"
    },
    "taxonomies": [
        {
            "code": "251G00000X",
            "taxonomy_group": "",
            "desc": "Hospice Care, Community Based",
            "state": "UT",
            "license": "2016",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "CareSource Hospice at Home",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Michael D Call, CRNA
• Annie Jane Xiao Xiao Cannon, PA-C
• Care Planning Institute, Inc
• Care Planning Institute, Inc
• Caresource
• Caresource L L C
• Karin Carestia
• Adam Haynes Carewe, MD
• Stephanie Castle, OD
• Catholic Health Initiatives Colorado (Orthopedics & Sports Medicine Park City)

• Community Based Hospice Care Agency in Park City, UT
• Providers in Park City, UT by specialty
• Community Based Hospice Care 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.