Individual provider Active NPI

Genevieve Noelle Olivier, PT, DPT, NCS

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1053820001
Registry record updated Jul 21, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8681805-2401 Issued in UT
Practice address
520 S Wakara Way
Salt Lake City, UT 84108-1213
Phone
(801) 587-9161
Fax
(801) 587-7607
NPI assigned
Sep 21, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2022

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8681805-2401 UT Primary
Neurology Physical Therapist 2251N0400X 8681805-2401 UT

Addresses

Primary practice location

520 S Wakara Way
Salt Lake City, UT 84108-1213

Mailing address

Balance & Mobility Clinic
520 Wakara Way
Salt Lake City, UT 84108
Phone (801) 587-9161

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address golivier275505@direct.med.utah.edu Direct UNIVERSITY OF UTAH

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180417001349 UT Practitioner - Physical Therapist in Private Practice 6800159252 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8681805-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Adult Services CurrentSince Mar 15, 2018 Accepting new patients
University of Utah Adult Services CurrentSince Mar 15, 2018 Accepting new patients
University of Utah Adult Services Current Accepting new patients

Locations

520 S Wakara Way
Slc, UT 84108
Phone (801) 585-7448

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

127 S 500 E
Ste 600
Slc, UT 84102

Organizations & group practices 3

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": "1505952000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1658361600000",
    "number": "1053820001",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "BALANCE & MOBILITY CLINIC",
            "address_2": "520 WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84108",
            "telephone_number": "801-587-9161",
            "fax_number": "801-587-7607"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "520 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081213",
            "telephone_number": "801-587-9161",
            "fax_number": "801-587-7607"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OLIVIER",
        "first_name": "GENEVIEVE",
        "middle_name": "NOELLE",
        "name_prefix": "Dr.",
        "credential": "PT, DPT, NCS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-09-21",
        "last_updated": "2022-07-21",
        "certification_date": "2021-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8681805-2401",
            "primary": true
        },
        {
            "code": "2251N0400X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Neurology",
            "state": "UT",
            "license": "8681805-2401",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "golivier275505@direct.med.utah.edu",
            "affiliation": "Y",
            "affiliationName": "UNIVERSITY OF UTAH",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 21, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.