CARESOURCE (NPI# 1902861693) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1902861693 |
| Entity Type | Organization |
| Organization Name | CARESOURCE |
| Other Organization Name | CARESOURCE HOME HEALTH AND HOSPICE |
| Practice Address |
750 Kearns Blvd. #200 Park City UT 84060 |
| Mailing Address |
Po Box 680839 750 Kearns Blvd. #200 Park City UT 84068 |
| Practice Telephone | 8012667200 |
| Practice Fax Number | 8012667004 |
| Mailing Telephone | 8012667200 |
| Mailing Fax Number | 8012667004 |
| Enumeration Date | 2006-04-18 |
| Last Update Date | 2016-11-14 |
| Authorized Official Name | MRS. SHAWNTEL ELIZABETH TANNER (CEO/ADMINISTRATOR) |
| Authorized Official Telephone | 8012667200 |
| Authorized Official Credential | MA |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 251E00000X | Home Health | 2006-HHA-912 | UT | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | TRADING PARTNER NUMBER | HT005376-001 | 01 |
| Other Name | Type Code |
|---|---|
| CareSource Home Health and Hospice | Other Name - Individual/Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548791916 | Caresource | Health Maintenance Organization | 230 N Main St, Dayton, OH 45402-1263 | 2017-03-27 |
| 1316490402 | Caresource | Skilled Nursing Facility | 1624 E 4500 S, Salt Lake City, UT 84117-4212 | 2016-07-26 |
| 1124242128 | Caresource | Family Medicine | 1624 E 4500 S, Salt Lake City, UT 84117-4212 | 2007-04-12 |
| Entity Type | Entity Name | Entity Address |
|---|---|---|
| System for Award Management (SAM) Entities | CARESOURCE | 230 N Main St, Dayton, OH 45402-1263 |
| Iowa Business Entities | CARESOURCE | 230 N Main St, Dayton, OH 45402 |
| Oregon Corporations, Companies and Business Names | CARESOURCE HEALTH PLAN | 1701 Ne 7th St, Grants Pass, OR 97526 |
| System for Award Management (SAM) Entities | CARESOURCE INCORPORATED | 6628 Gray Wolf Dr, Plano, TX 75024-6077 |
| Indiana Business Entities | CARESOURCE MANAGEMENT SERVICES CO. | P. O. Box 8738, 230 North Main Street, Dayton, OH 45401-8738 |
| Colorado Business Entities | CareSource Management Services LLC | 230 N. Main Street, Peyton, OH 45402 |
| Washington State Corporations | CARESOURCE MANAGEMENT SERVICES LLC | 230 N Main St, Dayton, OH 45402-1263 |
| System for Award Management (SAM) Entities | CARESOURCE ONE TRANSPORTATION | 7891 Johnson Street, Pembroke Pines, FL 33024-6848 |
| Street Address |
750 KEARNS BLVD. #200 |
| City | PARK CITY |
| State | UT |
| Zip Code | 84060 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1982233920 | Livecare, Inc. | Nursing Care | 1830 Prospector Avenue, Park City, UT 84060 | 2020-04-02 |
| 1063904266 | Louise Knetzger Gallagher | Acupuncturist | 1107 Woodside Ave, Park City, UT 84060 | 2018-06-04 |
| 1942753421 | Valerie Alison Mey | Dietitian, Registered | 2985 Arabian Dr, Park City, UT 84060 | 2016-08-01 |
| 1659720936 | Vibrant Health PC | Anesthesiology | 1910 Prospector Ave Suite 302, Park City, UT 84060 | 2016-06-08 |
| 1538538657 | Pamela Hilbert | Dentist | 1830 Prospector Ave., Park City, UT 84060 | 2015-09-18 |
| 1174904924 | Julie Anna Bullen | Counselor | 2300 Monitor Drive, Park City, UT 84060 | 2015-06-17 |
| 1265825319 | William Gary Smith | Obstetrics & Gynecology | 2501 Creek Drive, Park City, UT 84060 | 2015-03-13 |
| 1497026330 | Earl Warren Stadler Jr. | Physical Medicine & Rehabilitation | 1500 Three Kings Drive Unit 31, Park City, UT 84060 | 2012-01-24 |
| 1538454541 | Belinda Duncan | Pharmacist | 2700 E Deer Valley Dr B105, Park City, UT 84060 | 2011-06-17 |
| 1184888315 | Cody Michael Calderwood | Dentist | 1600 Snow Creek Dr Ste A, Park City, UT 84060 | 2008-07-16 |
| Find all providers in zip 84060 | ||||
| Taxonomy Code | 251E00000X |
| Grouping | Agencies |
| Classification | Home Health |
| A public agency or private organization, or a subdivision of such an agency or organization, that is primarily engaged in providing skilled nursing services and other therapeutic services, such as physical therapy, speech-language pathology services, or occupational therapy, medical social services, and home health aide services. It has policies established by a professional group associated with the agency or organization (including at least one physician and one registered nurse) to govern the services and provides for supervision of such services by a physician or a registered nurse; maintains clinical records on all patients; is licensed in accordance with State or local law or is approved by the State or local licensing agency as meeting the licensing standards, where applicable; and meets other conditions found by the Secretary of Health and Human Services to be necessary for health and safety. |
| Notes: Source: CFR42 Chapter IV Part 484, http://www.access.gpo.gov/nara/cfr/waisidx_99/42cfr484_99.html [7/1/2007: definition added, source added] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841497534 | Jean M Giampaolo | Home Health | 4471 Willow Creek Dr, Park City, UT 84098-6573 | 2007-06-27 |
| 1497979413 | Caresource L L C | Home Health | 750 Kearns Blvd # 200, Park City, UT 84060-5137 | 2007-04-12 |
| 1699174615 | Jasima Reynolds | Home Health | 1640 Redstone Center Dr, Suite 200, Park City, UT 84098-7605 | 2014-08-14 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1013518422 | Ascent Physical Therapy and Wellness | Home Health | 1549 W Haslam Cir, Salt Lake City, UT 84116-1633 | 2020-11-03 |
| 1528671039 | Permacare LLC | Home Health | 1079 E Riverside Dr Ste 202, St George, UT 84790-4734 | 2020-08-25 |
| 1740899640 | Inspiration Personal Care | Home Health | 1649 E 1400 S, Clearfield, UT 84015-2482 | 2020-07-27 |
| 1720609167 | Twilight Health, LLC | Home Health | 805 S 500 W Ste 6, Payson, UT 84651-3205 | 2020-04-27 |
| 1134754054 | Temple View Home Health & Hospice | Home Health | 1611 E 2450 S # 5a, St George, UT 84790-6285 | 2020-03-11 |
| 1174178255 | Sierra Home Health Care Slc, LLC | Home Health | 5411 S Vine St Unit 5b, Murray, UT 84107-7756 | 2019-08-06 |
| 1801440201 | Wasatch Worx Home Health | Home Health | 375 N Main St Ste 103, Kaysville, UT 84037-1272 | 2019-07-24 |
| 1508420928 | Atlantic Home Health Care, LLC | Home Health | 356 S Main St Ste 4, Blanding, UT 84511-3830 | 2019-05-01 |
| 1962960179 | Sierra Home Health Care, LLC | Home Health | 1173 S 250 W Ste 507b, St George, UT 84770-6392 | 2019-03-06 |
| 1356808653 | Nphalanx LLC | Home Health | 404 E 4500 S Ste B22, Salt Lake City, UT 84107-2776 | 2019-02-23 |
| Find all providers with the same taxonomy | ||||
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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.