NPIMap

Organization Active NPI

Core Rehabilitation and Spine Center

  • Physical Therapy Clinic/Center
  • Salt Lake City, UT
National Provider Identifier
1093810251
Registry record updated Aug 22, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical Therapy Clinic/CenterTaxonomy code 261QP2000X
License
6002870-0160 Issued in UT
Legal business name
CORE REHABILITATION AND SPINE CENTER
Practice address
4885 S 900 E
Suite 107
Salt Lake City, UT 84117-5746
Phone
(801) 979-4722
NPI assigned
Sep 13, 2006
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 22, 2020

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

Authorized official

Name
Irene Acevedo, MS, PT, CERT MDTNPI 1437254695
Title
Director
Phone
(801) 979-4722

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapy Clinic/Center 261QP2000X 6002870-0160 UT Primary

Addresses

Primary practice location

4885 S 900 E
Suite 107
Salt Lake City, UT 84117-5746

Mailing address

4885 S 900 E
Suite 107
Salt Lake City, UT 84117-5746
Phone (801) 979-4722

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1598054400000",
    "number": "1093810251",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4885 S 900 E",
            "address_2": "SUITE 107",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175746",
            "telephone_number": "801-979-4722"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4885 S 900 E",
            "address_2": "SUITE 107",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841175746",
            "telephone_number": "801-979-4722"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CORE REHABILITATION AND SPINE CENTER",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-09-13",
        "last_updated": "2020-08-22",
        "status": "A",
        "authorized_official_last_name": "ACEVEDO",
        "authorized_official_first_name": "IRENE",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "801-979-4722",
        "authorized_official_credential": "MS, PT, CERT MDT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "UT",
            "license": "6002870-0160",
            "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 Aug 22, 2020; 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.