Individual provider Active NPI

Michelle D Wellman, OT

  • Occupational Therapist
  • Riverton, UT
National Provider Identifier
1043488570
Registry record updated Jun 30, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
OT61194912 Issued in WA
Practice address
3741 W 12600 S Ste 200
Riverton, UT 84065-7215
Phone
(801) 285-3400
Fax
(801) 285-3401
NPI assigned
Feb 19, 2008
Last updated
Jun 30, 2022By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 30, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy Assistant 224Z00000X OC00001051 WA
Occupational Therapist 225X00000X OT61194912 WA Primary

Addresses

Primary practice location

3741 W 12600 S Ste 200
Riverton, UT 84065-7215

Mailing address

572 S Crooked Post Way
Saratoga Springs, UT 84045-5449
Phone (509) 851-3791

Other names 1

  • Michelle D Roblyer Former name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230821000028 UT Practitioner - Occupational Therapist in Private Practice 4385045566 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 2020
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

9450 S 1300
Sandy, UT 84094-5555
Phone (801) 501-2133

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
OC00001051WAMDOccupational Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Jun 19, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Jun 19, 2023 Accepting new patients
Inspire Physical & Hand Therapy Spokane Inc. P.S. Occupational Therapist Past Accepting new patients
Department of Social Dept of SHS Div of Instns PastSince Apr 10, 2012 Accepting new patients
Eastern State Hospital Pharmacy Past Accepting new patients

Locations

3741 W 12600 S
Ste 200
Riverton, UT 84065
Phone (801) 285-3400

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

9450 S 1300 E
Sandy, UT 84094
Phone (801) 501-2133

Organizations & group practices 5

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": "1203379200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1656547200000",
    "number": "1043488570",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "572 S CROOKED POST WAY",
            "city": "SARATOGA SPRINGS",
            "state": "UT",
            "postal_code": "840455449",
            "telephone_number": "509-851-3791",
            "fax_number": "801-285-4301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3741 W 12600 S STE 200",
            "city": "RIVERTON",
            "state": "UT",
            "postal_code": "840657215",
            "telephone_number": "801-285-3400",
            "fax_number": "801-285-3401"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WELLMAN",
        "first_name": "MICHELLE",
        "middle_name": "D",
        "name_prefix": "Ms.",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2008-02-19",
        "last_updated": "2022-06-30",
        "certification_date": "2022-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapy Assistant",
            "state": "WA",
            "license": "OC00001051",
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "WA",
            "license": "OT61194912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELLE",
            "last_name": "ROBLYER",
            "middle_name": "D",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

Other providers in Riverton, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.