SHANE POULSEN (NPI# 1427606128) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1427606128 |
| Entity Type | Individual |
| Full Name | SHANE POULSEN |
| Practice Address |
237 26th St Ogden UT 84401-3105 |
| Practice Telephone | 8016253700 |
| Enumeration Date | 2019-08-27 |
| Last Update Date | 2019-08-27 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 171M00000X | Case Manager/Care Coordinator | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | RAILROAD MEDICARE | 260022408 | 01 |
| UT | 8760003008007 | 05 | |
| UT | MEDICARE PIN | 000055266 | 01 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1710247788 | Shane Poulsen | Community Health Worker | 1344 W State Rd, Pleasant Grove, UT 84062-5022 | 2012-05-23 |
| Street Address |
237 26TH ST |
| City | OGDEN |
| State | UT |
| Zip Code | 84401-3105 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1922004209 | Teresa Ramos | Nurse Practitioner | 237 26th St, Ogden, UT 84401-3105 | 2005-06-22 |
| 1114525458 | Allsion Cooper | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-10-09 |
| 1164035226 | Brinley Roubinet | Community Health Worker | 237 26th St, Ogden, UT 84401-3105 | 2020-08-28 |
| 1679186647 | Salena Echevarria | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-08-28 |
| 1780296798 | Donna Lori King | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-08-20 |
| 1225649338 | Lori Ludlow | Counselor | 237 26th St, Ogden, UT 84401-3105 | 2020-08-12 |
| 1336750538 | Christy Rundio | Counselor | 237 26th St, Ogden, UT 84401-3105 | 2020-08-11 |
| 1083225288 | Tommi King | Counselor | 237 26th St, Ogden, UT 84401-3105 | 2020-08-11 |
| 1396355087 | Weber Human Services | Family Medicine | 237 26th St, Ogden, UT 84401-3105 | 2020-08-06 |
| 1902424252 | Madison Jarvis | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-07-13 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1376183558 | Vickie Fields | Counselor | 533 26th Street Ste 100, Ogden, UT 84401 | 2020-01-15 |
| 1063059939 | Gahc4 West Haven Ut Trs Sub, LLC | Assisted Living Facility | 3518 South 2625 West, West Haven, UT 84401 | 2019-12-10 |
| 1720631880 | Kelsey Askea | Student in an Organized Health Care Education/Training Program | 2261 Washington Blvd #102, Ogden, UT 84401 | 2019-07-18 |
| 1114579596 | James Edward Fenton Jr. | Nurse Practitioner | 2351 Grant Ave Ste 201, Ogden, UT 84401 | 2019-07-15 |
| 1689144248 | Crystal Hadley | Registered Nurse | 477 23rd Street, Ogden, UT 84401 | 2018-11-27 |
| 1336632215 | Michael David Leman | Registered Nurse | 1355 Hinckley Dr, Ogden, UT 84401 | 2018-06-14 |
| 1689926313 | Lotus Park Care Centers, LLC | Assisted Living Facility | 2639 W 3520 S, West Haven, UT 84401 | 2012-10-04 |
| 1770865776 | William M Gardiner | Social Worker | 2351 Grant, Suite 103, Ogden, UT 84401 | 2011-09-15 |
| 1043509888 | Absolute Vision | Optometrist | 4645 S. Midland Dr., Suite A, West Haven, UT 84401 | 2011-04-01 |
| 1629376496 | Chad Calkins | Counselor | 502 E 22nd St, Ogden, UT 84401 | 2011-03-03 |
| Find all providers in zip 84401 | ||||
| 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 |
|---|---|---|---|---|
| 1669694634 | Christine Amber Mccleve | Case Manager/Care Coordinator | 237 26 St, Ogden, UT 84401 | 2007-05-02 |
| 1053532846 | Lisa Schofield | Case Manager/Care Coordinator | 237 26th St., Ogden, UT 84401 | 2007-05-01 |
| 1396964458 | Susanh Chapple Hadley | Case Manager/Care Coordinator | 237 26 Street, Ogden, UT 84401-9946 | 2007-04-25 |
| 1114525458 | Allsion Cooper | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-10-09 |
| 1679186647 | Salena Echevarria | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-08-28 |
| 1780296798 | Donna Lori King | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-08-20 |
| 1902424252 | Madison Jarvis | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-07-13 |
| 1013543925 | Jason Pepper | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-03-23 |
| 1366078263 | Mackenzie Cardon | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-03-23 |
| 1902431570 | Margaret Karegeannes | Case Manager/Care Coordinator | 237 26th St, Ogden, UT 84401-3105 | 2020-03-04 |
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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.