Active NPI
Stephanie Lockingen, PT
- Physical Therapist
- Murray, UT
National Provider Identifier
1104480078
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 11225890-2401
- Practice address
- 5171 S Cottonwood St Ste 630
Murray, UT 84107-5704 - Phone
- (801) 507-3967
- NPI assigned
- Apr 26, 2019
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 11225890-2401 | UT | Primary |
Addresses
Primary practice location
5171 S Cottonwood St Ste 630
Murray, UT 84107-5704
Mailing address
5045 Comstock Cir
Fort Worth, TX 76244-6798
Phone (817) 602-0639
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 11225890-2401 | Other | UT | PHYSICAL THERAPY LICENSE |
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | Stephanie.Lockingen@imail.org |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2001
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
Practice addresses (Care Compare)
5171 S Cottonwood St
Suite 900
Murray, UT 84107-5704
Phone (801) 507-2050
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 11225890-2401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Ihc Health Services Inc | Physical Therapist | Current | Accepting new patients |
| Ihc Health Services, Inc. | Current | Accepting new patients |
Locations
5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050
Interoperability endpoints
- stephanie.lockingen@imail.org
Organizations & group practices 2
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.
-
- Rehabilitation Clinic/Center
- Salt Lake City, UT
- NPI 1033822085
Physical Therapist
-
- Psychiatry Physician
- St George, UT
- NPI 1023843844
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1556236800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1556236800000",
"number": "1104480078",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5045 COMSTOCK CIR",
"city": "FORT WORTH",
"state": "TX",
"postal_code": "762446798",
"telephone_number": "817-602-0639"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5171 S COTTONWOOD ST STE 630",
"city": "MURRAY",
"state": "UT",
"postal_code": "841075704",
"telephone_number": "801-507-3967"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LOCKINGEN",
"first_name": "STEPHANIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2019-04-26",
"last_updated": "2019-04-26",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "11225890-2401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PHYSICAL THERAPY LICENSE",
"identifier": "11225890-2401",
"state": "UT"
}
],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "Stephanie.Lockingen@imail.org",
"affiliation": "N",
"endpointDescription": "email",
"address_1": "5171 S Cottonwood St Ste 630",
"city": "Murray",
"state": "UT",
"country_code": "US",
"postal_code": "841075704",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}
Other providers in Murray, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 26, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.