Individual provider Active NPI

Rodney A Miyasaki, PT

  • Physical Therapist
  • Taylorsville, UT
National Provider Identifier
1073546040
Registry record updated Aug 3, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
1079462401 Issued in UT
Practice address
5547 S 4015 W
#7
Taylorsville, UT 84129-4429
Phone
(801) 967-6055
Fax
(801) 967-6934
NPI assigned
Jul 10, 2006
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 3, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 1079462401 UT Primary

Addresses

Primary practice location

5547 S 4015 W
#7
Taylorsville, UT 84129-4429

Mailing address

5547 So 4015 W
Westwood Physical Therapy Clinic #7
Taylorsville, UT 84129-4429
Phone (801) 967-6055

Other identifiers 10

IdentifierTypeStateIssuer
44035OtherUTPEHP
6400110OtherUTUHC
107000445102OtherUTPHC
265950OtherUTDMBA
42673OtherUTFIRST HEALTH
NO261MedicaidUT
190100500OtherUTOWCP
650013190OtherUTRR MEDICARE
QM0000076206OtherUTALTIUS
3269413001OtherUTCIGNA

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

State licenses

LicenseStateTypeSpecialty
1079462401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1152489600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1312329600000",
    "number": "1073546040",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5547 SO 4015 W",
            "address_2": "WESTWOOD PHYSICAL THERAPY CLINIC #7",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841294429",
            "telephone_number": "801-967-6055",
            "fax_number": "801-967-6934"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5547 S 4015 W",
            "address_2": "#7",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841294429",
            "telephone_number": "801-967-6055",
            "fax_number": "801-967-6934"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIYASAKI",
        "first_name": "RODNEY",
        "middle_name": "A",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-07-10",
        "last_updated": "2011-08-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "1079462401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "44035",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UHC",
            "identifier": "6400110",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHC",
            "identifier": "107000445102",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "265950",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "FIRST HEALTH",
            "identifier": "42673",
            "state": "UT"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "NO261",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OWCP",
            "identifier": "190100500",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE",
            "identifier": "650013190",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000076206",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "3269413001",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; 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.