CARESOURCE
NPI 1124242128
Family Medicine - Hospice and Palliative Medicine in Salt Lake City, UT
- Organization
- Family Medicine
- Hospice and Palliative Medicine
About CARESOURCE
This page provides the complete NPI Profile along with additional information for Caresource, a provider established in Salt Lake City, Utah operating as a Family Medicine, focusing in hospice and palliative medicine . The healthcare provider is registered in the NPI registry with number 1124242128 assigned on April 2007. The practitioner's primary taxonomy code is 207QH0002X with license number 5221090-1205 (UT). The provider is registered as an organization and their NPI record was last updated one year ago. Caresource operates as a Multi-Specialty Group with one or more individual practitioners, who practice different areas of specialization. The authorized official of this NPI record is Mrs. Shawntel Tanner Ma (Administrator)
- NPI
- 1124242128 Verify this NPI
- Provider Name
- CARESOURCE
- Other Name Type
- (6)
- Entity Type
- Organization
- Location Address
- 1624 E 4500 S SALT LAKE CITY, UT 84117
- Location Phone
- (801) 266-7200
- Location Fax
- (801) 266-7004
- Mailing Address
- 1624 E 4500 S SALT LAKE CITY, UT 84117
- Mailing Phone
- (801) 266-7200
- Mailing Fax
- (801) 266-7004
- Is Sole Proprietor?
- No
- Is Organization Subpart?
- No
- Enumeration Date
- 04-12-2007
- Last Update Date
- 09-11-2025
- Code Navigator
Location Map
Specialty - Primary Taxonomy
The NPI enumerator requires providers to submit at least one taxonomy code. A taxonomy code is a unique 10-character code that describes the healthcare provider type, classification, and the area of specialization. There could be only one primary taxonomy code per NPI record. For individual NPIs the license data is associated to the taxonomy code.
- Classification
Family Medicine Hospice and Palliative Medicine
- Taxonomy Code
- 207QH0002X
- Type
- Allopathic & Osteopathic Physicians
- License No.
- 5221090-1205
- License State
- UT
- Taxonomy Description
- 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.
Secondary Taxonomies
The provider has reported to the NPI enumerator additional taxonomy codes. Multiple taxonomy codes may represent subspecialties or other areas of specialization the provider maybe licensed to practice.
| No. | Taxonomy Code | Type | Classification / Specialization |
License No. (State) |
|---|---|---|---|---|
| 1 | 207Q00000X | Allopathic & Osteopathic Physicians | Family Medicine | 5221090-1205 (UT) |
Group Taxonomy 193200000X MULTI-SPECIALTY GROUP
This provider is a business group of one or more individual practitioners, who practice with different areas of specialization.
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Other Providers at the Same Location
The following 6 providers are registered at the same or a nearby location.
HOLLADAY, UT 84117
Frequently Asked Questions
The NPI number assigned to this healthcare provider is 1124242128, enumerated as an "organization" on April 12, 2007.
The provider is located at 1624 E 4500 S SALT LAKE CITY, UT 84117 and the phone number is (801) 266-7200.
Family Medicine with taxonomy code 207QH0002X and a focus in Hospice and Palliative Medicine.
