CARESOURCE
NPI 1124242128
Family Medicine - Hospice and Palliative Medicine in Salt Lake City, UT

Q: What is Caresource's NPI number?

The NPI number for Caresource is 1124242128. It was assigned to this organization in the NPPES registry on April 12, 2007. The provider is also known as CareSource Senior Supportive Care Center.

Q: What is Caresource's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

Q: When was this NPI record last updated?

The NPPES record for Caresource was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.

Active since April 12, 2007

1624 E 4500 S, SALT LAKE CITY, UT 84117(801) 266-7200(801) 266-7004 Get Directions Write a Review

NPPES record last updated: September 11, 2025. Verified against the NPPES registry weekly; last sync: August 09, 2026.

Record update history: Sep 11, 2025, Aug 22, 2020 (2 updates tracked since 2020).

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About Caresource NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

CARESOURCE (NPI 1124242128) is a healthcare organization registered as a hospice and palliative medicine in Salt Lake City, Utah and active in the NPI registry since April 2007. The organization lists Shawntel Tanner, Administrator, as its authorized official.

NPPES Registry Identity

NPI1124242128

Entity TypeOrganization

Primary Taxonomy207QH0002X

Legal Business NameCARESOURCE

Location Address1624 E 4500 SSalt Lake City, UT 84117-4212

Mailing Address1624 E 4500 SSalt Lake City, UT 84117-4212 · (801) 266-7200 · Fax (801) 266-7004

Phone(801) 266-7200

Fax(801) 266-7004

Organization SubpartNo

Authorized OfficialShawntel TannerAdministrator · (801) 266-7200

Enumeration DateApril 12, 2007

Last NPPES UpdateSeptember 11, 20252 updates tracked since enumeration

✔ NPI 1124242128 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses 2

★ Primary SpecialtyFamily Medicine · Hospice and Palliative MedicineAllopathic & Osteopathic Physicians

Taxonomy Code207QH0002X

License✔ Licensed in UT · 5221090-1205

Definition

A family medicine physician with special knowledge and skills to prevent and relieve the suffering experienced by patients with life-limiting illnesses. This specialist works with an interdisciplinary hospice or palliative care team to maximize quality of life while addressing physical, psychological, social and spiritual needs of both patient and family throughout the course of the disease, through the dying process, and beyond for the family. This specialist has expertise in the assessment of patients with advanced disease; the relief of distressing symptoms; the coordination of interdisciplinary patient and family-centered care in diverse venues; the use of specialized care systems including hospice; the management of the imminently dying patient; and legal and ethical decision making in end-of-life care.

Also ListedFamily MedicineTaxonomy 207Q00000X · License 5221090-1205 (UT)

1624 E 4500 S, Salt Lake City, UT 84117

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Other Names 1

Other NameCaresource Senior Supportive Care Center

Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-SPECIALTY GROUP

Other Providers at the Same Location NPPES 6

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

MR. YANNI B GALLAGHER AMFT

Marriage & Family Therapist

1624 E 4500 S
MILLCREEK, UT 84117

Salt Lake County (855) 701-2721

CARESOURCE LLC

Hospice Care, Community Based

1624 E 4500 S
SALT LAKE CITY, UT 84117

Salt Lake County (801) 266-7200

CARESOURCE

Skilled Nursing Facility

1624 E 4500 S
SALT LAKE CITY, UT 84117

Salt Lake County (801) 266-7200

LODGE BY VALEO, LLC

Hospice, Inpatient

1624 E 4500 S
SALT LAKE CITY, UT 84117

Salt Lake County (801) 639-0020

STEPHEN B SMITH MD

Internal Medicine (Hospice and Palliative Medicine)

1624 E 4500 S
HOLLADAY, UT 84117

Salt Lake County (801) 266-7200

ASCENT BEHAVIORAL HOSPITAL LLC

Psychiatric Hospital

1624 E 4500 S
MILLCREEK, UT 84117

Salt Lake County (801) 491-2270

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Caresource's NPI number?

The NPI number for Caresource is 1124242128. It was assigned to this organization in the NPPES registry on April 12, 2007. The provider is also known as CareSource Senior Supportive Care Center.

Where is Caresource located?

Caresource is located at 1624 E 4500 S, Salt Lake City, UT 84117. The listed phone number is (801) 266-7200.

What is Caresource's specialty?

The primary specialty registered for this NPI is Family Medicine, specializing in Hospice and Palliative Medicine, with taxonomy code 207QH0002X.

When was this NPI record last updated?

The NPPES record for Caresource was last updated on September 11, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.