Individual provider Active NPI

David Stallings Jensen, MSPT

  • Physical Therapist
  • Sandy, UT
National Provider Identifier
1003999533
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
332841-2401 Issued in UT
Practice address
1803 Abbedale LN
Sandy, UT 84092-3847
Phone
(801) 619-0483
NPI assigned
Oct 20, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 332841-2401 UT Primary

Addresses

Primary practice location

1803 Abbedale LN
Sandy, UT 84092-3847

Mailing address

1803 Abbedale LN
Sandy, UT 84092-3847
Phone (801) 619-0483

Other identifiers 1

IdentifierTypeStateIssuer
03328412405-001OtherUTBCBS PROVIDER NUMBER

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
332841-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Bod Squad, LLC, the Physical Therapist PastSince Apr 3, 2009 Accepting new patients
Frogley Holding LLC Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1161302400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1003999533",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1803 ABBEDALE LN",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840923847",
            "telephone_number": "801-619-0483"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1803 ABBEDALE LN",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840923847",
            "telephone_number": "801-619-0483"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JENSEN",
        "first_name": "DAVID",
        "middle_name": "STALLINGS",
        "credential": "MSPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-20",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "332841-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS PROVIDER NUMBER",
            "identifier": "03328412405-001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.