WHITNIE BLAKE BOULTON (NPI# 1083267272) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1083267272 |
| Entity Type | Individual |
| Full Name | WHITNIE BLAKE BOULTON |
| Practice Address |
716 E 4500 S Ste N160 Murray UT 84107-3617 |
| Mailing Address |
Po Box 520009 Slc UT 84152-0009 |
| Practice Telephone | 8012811100 |
| Practice Fax Number | 8012811936 |
| Mailing Telephone | 8012811100 |
| Mailing Fax Number | 8012811936 |
| Enumeration Date | 2019-07-17 |
| Last Update Date | 2019-07-17 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| Street Address |
716 E 4500 S STE N160 |
| City | MURRAY |
| State | UT |
| Zip Code | 84107-3617 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1407297310 | Teresa Hartman | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107 | 2013-07-09 |
| 1104437243 | Colleen Parker | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-08-12 |
| 1902415136 | Stephanie Stathis | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-07-23 |
| 1881211506 | Jennifer Elaine Lamont | Social Worker | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-06-29 |
| 1922631381 | Secadio Sanchez | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-02-13 |
| 1215594478 | Amy Larsen | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2019-05-23 |
| 1740845338 | Lindsay Nicole Roye | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2019-05-08 |
| 1669037990 | Kelly Lynn Thomas | Social Worker | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2019-05-02 |
| 1144795303 | Andy Zane Deines | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2018-10-03 |
| 1194215780 | Sonia Edith Torres | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2018-05-18 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1902410517 | Brielle Nicole Poulter | Student in an Organized Health Care Education/Training Program | 345 East 4500 So #260, Murray, UT 84107 | 2020-09-01 |
| 1467016592 | Ashlee Brown | Social Worker | C-134, 5284 Commerce Drive, Murray, Murray, UT 84107 | 2019-04-24 |
| 1568940633 | Samantha Duff | Occupational Therapist | 5770 S Fashion Blvd, Bldg 5 Ste 201, Murray, UT 84107 | 2018-08-01 |
| 1881185247 | Derek John Sharp | Occupational Therapist | 5770 S Fashion Blvd, Bldg #5, Suite 210, Murray, UT 84107 | 2018-05-22 |
| 1093223091 | Erin Nicole Hill | Counselor | 345 East 4500 South Suite 260, Murray, UT 84107 | 2018-01-12 |
| 1588171219 | Nicole Danielle Jensen | Counselor | 345 East 4500 South, Suite 260, Murray, UT 84107 | 2018-01-03 |
| 1043725799 | Greater Endodontics LLC | Dentist | 5334 South Woodrow Street, Suite 201, Salt Lake City, UT 84107 | 2017-12-04 |
| 1043739667 | Karyn K Hodge | Audiologist | 4500 So. 777. E. Ste #110, Murray, UT 84107 | 2017-09-14 |
| 1912426750 | Brandon C Burton | Specialist/Technologist, Other | Cta Community Supports 4444 S, 700 E Suite 203, Salt Lake City, UT 84107 | 2017-09-13 |
| 1396261152 | Megan Lehane Delano | Plastic Surgery | 5169 Cottonwood St Ste 420, Murray, UT 84107 | 2017-08-14 |
| Find all providers in zip 84107 | ||||
| Taxonomy Code | 171M00000X |
| Grouping | Other Service Providers |
| Classification | Case Manager/Care Coordinator |
| A person who provides case management services and assists an individual in gaining access to needed medical, social, educational, and/or other services. The person has the ability to provide an assessment and review of completed plan of care on a periodic basis. This person is also able to take collaborative action to coordinate the services with other providers and monitor the enrollee’s progress toward the cost-effective achievement of objectives specified in the plan of care. Credentials may vary from an experience in the fields of psychology, social work, rehabilitation, nursing or a closely related human service field, to a related Assoc of Arts Degree or to nursing credentials. Some states may require certification in case management. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: new] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1821636937 | Traci Lynn Newland | Case Manager/Care Coordinator | 5280 S Commerce Dr, Murray, UT 84107-7929 | 2019-12-19 |
| 1053892349 | Alaysha Arlene Gwen Kingsley | Case Manager/Care Coordinator | 716 E 4500 S # 160, Murray, UT 84107-3080 | 2018-08-24 |
| 1407297310 | Teresa Hartman | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107 | 2013-07-09 |
| 1104437243 | Colleen Parker | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-08-12 |
| 1902415136 | Stephanie Stathis | Case Manager/Care Coordinator | 716 E 4500 S Ste N160, Murray, UT 84107-3617 | 2020-07-23 |
| 1790303246 | Raneka Sydni Jackson | Case Manager/Care Coordinator | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1205454758 | Lenora L Glass | Case Manager/Care Coordinator | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1932727484 | Anna-marie Zaccardi Grow | Case Manager/Care Coordinator | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1528686078 | Vittoria Rosaria Zaccardi Jackson | Case Manager/Care Coordinator | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| 1801414354 | Nicole E Garrett | Case Manager/Care Coordinator | 5047 S Galleria Drive, Murray, UT 84123 | 2020-07-10 |
| Find all providers in MURRAY | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.