Individual provider Active NPI

Terry R Routt, LCSW

  • Clinical Social Worker
  • Orem, UT
National Provider Identifier
1023212644
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
134709-3501 Issued in UT
Practice address
570 E 1400 S
Orem, UT 84097-7714
Phone
(801) 426-6661
Fax
(801) 426-6660
NPI assigned
Jun 14, 2007
Last updated
Jul 8, 2007By the provider in NPPES
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
Clinical Social Worker 1041C0700X 134709-3501 UT Primary

Addresses

Primary practice location

570 E 1400 S
Orem, UT 84097-7714

Mailing address

756 W 1150 S
Provo, UT 84601-5542
Phone (801) 371-0968

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070730000531 UT Practitioner - Clinical Social Worker 8820199219 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
May accept Medicare assignment
Group practices
Chrysalis Utah, LLCGroup PAC ID 4284735846, 5 clinicians

Practice addresses (Care Compare)

1443 W 800
Suite 103
Orem, UT 84057-2878

1507 S 180
Provo, UT 84606-5570
Phone (801) 655-4950

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
134709-3501UTMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Chrysalis Utah, LLC CurrentSince Jul 1, 2006 Accepting new patients
Chrysalis Utah, Inc. Past Accepting new patients

Locations

1443 W 800 N
Ste 103
Orem, UT 84057
Phone (801) 604-1455

570 E 1400 S
Orem, UT 84097
Phone (801) 426-6661

1507 S 180 E
Provo, UT 84606
Phone (801) 426-6661

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1181779200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1023212644",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "756 W 1150 S",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846015542",
            "telephone_number": "801-371-0968"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "570 E 1400 S",
            "city": "OREM",
            "state": "UT",
            "postal_code": "840977714",
            "telephone_number": "801-426-6661",
            "fax_number": "801-426-6660"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ROUTT",
        "first_name": "TERRY",
        "middle_name": "R",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2007-06-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "UT",
            "license": "134709-3501",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Orem, UT

Sources for this page

Verify at the official NPI Registry.