MACKENZIE HEATHER BLUNDELL (NPI# 1215405048) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1215405048 |
| Entity Type | Individual |
| Full Name | MACKENZIE HEATHER BLUNDELL |
| Practice Address |
1020 S Main St Salt Lake City UT 84101-3176 |
| Mailing Address |
4460 S Highland Dr Salt Lake City UT 84124-3543 |
| Practice Telephone | 8015397000 |
| Practice Fax Number | 8015397050 |
| Enumeration Date | 2018-11-09 |
| Last Update Date | 2018-11-09 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | UT | Other Service Providers |
| Street Address |
1020 S MAIN ST |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84101-3176 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1659355790 | James D. Ricciardi | Psychologist | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2005-12-02 |
| 1861958506 | Pamrose Sitake | Registered Nurse | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-02-19 |
| 1821562760 | Christopher Davis | Pharmacy Technician | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-14 |
| 1346713732 | Eric Sitta | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2019-01-08 |
| 1588132724 | Natalie Jeanine Williams | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-11-06 |
| 1609343482 | Sophia Renee Felix | Community Health Worker | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-10-30 |
| 1437630431 | Mark J Sanchez | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| 1174004196 | Kristin Emily Olsen | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| 1912488990 | Zachary Staton Tucker | Behavioral Analyst | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-27 |
| 1568941193 | Dallas Lewis | Pharmacist | 1020 S Main St, Salt Lake City, UT 84101-3176 | 2018-08-14 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1053804237 | Holly Smith | Registered Nurse | 1020 S Main Street, Salt Lake City, UT 84101 | 2018-06-12 |
| 1174999627 | Justin Williams | Social Worker | 155 W. 300 S., Salt Lake City, UT 84101 | 2015-08-19 |
| 1902291842 | Daryl Ray Ezidore | Student in an Organized Health Care Education/Training Program | 100 South 344 East, Salt Lake City, UT 84101 | 2015-03-30 |
| 1104190859 | Luxottica of America Inc. | Eyewear Supplier (Equipment, not the service) | 50 S Main St Ste 115, Salt Lake City, UT 84101 | 2012-02-28 |
| 1366713307 | Gonstead Family Chiropractic | Chiropractor | 1154 S. 300 W., Suite C, Salt Lake City, UT 84101 | 2012-01-23 |
| 1659544880 | Jeffrey Daniel | Registered Nurse | 404 South 400 West, Salt Lake City, UT 84101 | 2008-04-09 |
| 1306030580 | Christopher Dean Chapman | Chiropractor | 345 W 100 S Ste 6c, Salt Lake City, UT 84101 | 2007-08-30 |
| 1689713497 | Walter Landon Bye | Dentist | 15 West South Temple, Gateway Tower West Suite 440, Salt Lake City, UT 84101 | 2007-02-06 |
| 1154403152 | Allison Miller Gardner | Physical Therapist | 84 West 700 South, Salt Lake City, UT 84101 | 2006-10-19 |
| 1780655407 | Frederick Van Der Veur | Social Worker | 1020 South Main Street, 242, Salt Lake City, UT 84101 | 2006-01-30 |
| Find all providers in zip 84101 | ||||
| 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 |
|---|---|---|---|---|
| 1689281818 | Devery White | Case Manager/Care Coordinator | 195 N 1900 W, Salt Lake City, UT 84116 | 2020-10-01 |
| 1326652116 | Brenna Colleen Ball | Case Manager/Care Coordinator | 671 N Oakley St, Salt Lake City, UT 84116-3833 | 2020-08-31 |
| 1437761368 | Tonia Price | Case Manager/Care Coordinator | 625 S 200 E, Salt Lake City, UT 84111-3801 | 2020-08-21 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1619502374 | Bradford Nielson | Case Manager/Care Coordinator | 344 E 100 S # B, Salt Lake City, UT 84111-1700 | 2020-03-03 |
| 1225662521 | Rob Lequia | Case Manager/Care Coordinator | 344 E 100 S # 344e100s, Salt Lake City, UT 84111-1700 | 2020-02-25 |
| 1154970507 | Lori Cerar | Case Manager/Care Coordinator | 230 W 200 S Ste 142, Salt Lake City, UT 84101-1337 | 2019-09-09 |
| 1457907776 | Christina Lee Oppenheimer | Case Manager/Care Coordinator | 230 W 200 S # 142, Salt Lake City, UT 84101-1337 | 2019-08-13 |
| 1184196230 | Roselia Yanella Chavez | Case Manager/Care Coordinator | 1233 W 700 S, Salt Lake City, UT 84104-2657 | 2018-12-28 |
| 1588149132 | Madeleine Smith | Case Manager/Care Coordinator | 344 E 1st S, Salt Lake City, UT 84111-1700 | 2018-09-29 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84101 |
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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.