Individual provider Active NPI

Sharon Lewis Burt, LMFT

  • Marriage & Family Therapist
  • American Fork, UT
National Provider Identifier
1104040351
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Marriage & Family TherapistTaxonomy code 106H00000X
License
6212924-3902 Issued in UT
Practice address
433 South 500 East
American Fork, UT 84003-2527
Phone
(180) 121-6800
Fax
(801) 216-8001
NPI assigned
Apr 12, 2007
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Marriage & Family Therapist 106H00000X 6212924-3902 UT Primary

Addresses

Primary practice location

433 South 500 East
American Fork, UT 84003-2527

Mailing address

4379 Mile High Dr.
Provo, UT 84604-6308
Phone (180) 143-4431

Other identifiers 1

IdentifierTypeStateIssuer
6212924-3902OtherUTLICENSED MFT

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
6212924-3902UTMDMarriage & Family Therapist

NPI Registry JSON

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

{
    "created_epoch": "1176336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1104040351",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4379 MILE HIGH DR.",
            "city": "PROVO",
            "state": "UT",
            "postal_code": "846046308",
            "telephone_number": "180-143-4431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "433 SOUTH 500 EAST",
            "city": "AMERICAN FORK",
            "state": "UT",
            "postal_code": "840032527",
            "telephone_number": "180-121-6800",
            "fax_number": "801-216-8001"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BURT",
        "first_name": "SHARON",
        "middle_name": "LEWIS",
        "credential": "LMFT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-04-12",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "106H00000X",
            "taxonomy_group": "",
            "desc": "Marriage & Family Therapist",
            "state": "UT",
            "license": "6212924-3902",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED MFT",
            "identifier": "6212924-3902",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in American Fork, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.