Active NPI
Connie South
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1043435985
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 2124
- Practice address
- 1952 Fort Union Blvd Ste 100
Salt Lake City, UT 84121-6878 - Phone
- (801) 942-3311
- Fax
- (801) 495-5303
- NPI assigned
- Apr 16, 2007
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2124 | NV | Primary |
Addresses
Primary practice location
1952 Fort Union Blvd Ste 100
Salt Lake City, UT 84121-6878
Mailing address
PO Box 711185
Salt Lake City, UT 84171-1185
Phone (801) 942-3311
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
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1176681600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1043435985",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "PO BOX 711185",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841711185",
"telephone_number": "801-942-3311",
"fax_number": "801-495-5303"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1952 FORT UNION BLVD STE 100",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841216878",
"telephone_number": "801-942-3311",
"fax_number": "801-495-5303"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOUTH",
"first_name": "CONNIE",
"name_prefix": "Miss",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-04-16",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "NV",
"license": "2124",
"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 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.