Senator Elliot Wilson

Primary specialty

Massage TherapistTaxonomy code 225700000X

License

8525090-4701 Issued in UT

Practice address

3435 E Pony Express Pkwy Ste 120
Eagle Mountain, UT 84005-5520

Phone

(801) 996-7911

NPI assigned

May 18, 2023

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Summit Spa & Float - Eagle Mountain LLC

  • Health Service Clinic/Center
  • Eagle Mountain, UT
  • NPI 1154048650
  NPD

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

{
    "created_epoch": "1684368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1684368000000",
    "number": "1063103141",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3435 E PONY EXPRESS PKWY STE 120",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055520",
            "telephone_number": "801-996-7911"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3435 E PONY EXPRESS PKWY STE 120",
            "city": "EAGLE MOUNTAIN",
            "state": "UT",
            "postal_code": "840055520",
            "telephone_number": "801-996-7911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WILSON",
        "first_name": "SENATOR",
        "middle_name": "ELLIOT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-05-18",
        "last_updated": "2023-05-18",
        "certification_date": "2023-05-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225700000X",
            "taxonomy_group": "",
            "desc": "Massage Therapist",
            "state": "UT",
            "license": "8525090-4701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Abril Wells, LMT
• Brett Allen White, FNP-C
• Stephen Michael White, DDS
• Greg Rogers Whitney, THERAPIST
• Tarrence Joshua Williams, DPT
• Jaelynn Winn, RPH
• Ailene Wood
• Bethany Marie Wood, MOT, OTR
• Monique Young
• Zion Recovery

• Massage Therapist in Eagle Mountain, UT
• Providers in Eagle Mountain, UT by specialty
• Massage Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 18, 2023; 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.