Individual provider Active NPI

Suzan Manville, BS, BA

  • Behavior Analyst
  • Salt Lake City, UT
National Provider Identifier
1023418084
Registry record updated Aug 27, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Behavior AnalystTaxonomy code 103K00000X
Practice address
2550 S Main St
Apt 1307
Salt Lake City, UT 84115-3001
Phone
(801) 448-9067
NPI assigned
Aug 27, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2014

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Behavior Analyst 103K00000X Primary

Addresses

Primary practice location

2550 S Main St
Apt 1307
Salt Lake City, UT 84115-3001

Mailing address

2550 S Main St
Apt 1307
Salt Lake City, UT 84115-3001
Phone (801) 448-9067

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)
Not enrolled
Credentials
Bachelor of Arts, Bachelor of Science

NPI Registry JSON

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

{
    "created_epoch": "1409097600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1409097600000",
    "number": "1023418084",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2550 S MAIN ST",
            "address_2": "APT 1307",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153001",
            "telephone_number": "801-448-9067"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2550 S MAIN ST",
            "address_2": "APT 1307",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841153001",
            "telephone_number": "801-448-9067"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MANVILLE",
        "first_name": "SUZAN",
        "credential": "BS, BA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-08-27",
        "last_updated": "2014-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103K00000X",
            "taxonomy_group": "",
            "desc": "Behavior Analyst",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 27, 2014; 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.