Active NPI
Sara Church
- Recreation Therapist
- West Valley City, UT
National Provider Identifier
1114781473
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Recreation Therapist
- License
- 10684127-4002
- Practice address
- 4090 W Pioneer Pkwy
West Valley City, UT 84120-2060 - Phone
- (801) 397-4426
- NPI assigned
- Feb 7, 2024
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Recreation Therapist | 225800000X | 10684127-4002 | UT | Primary |
Addresses
Primary practice location
4090 W Pioneer Pkwy
West Valley City, UT 84120-2060
Mailing address
1245 N 700 E
Bountiful, UT 84010-2507
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10684127-4002 | UT | MD | Recreation Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1707264000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1707264000000",
"number": "1114781473",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1245 N 700 E",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840102507"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4090 W PIONEER PKWY",
"city": "WEST VALLEY CITY",
"state": "UT",
"postal_code": "841202060",
"telephone_number": "801-397-4426"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CHURCH",
"first_name": "SARA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-02-07",
"last_updated": "2024-02-07",
"certification_date": "2024-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225800000X",
"taxonomy_group": "",
"desc": "Recreation Therapist",
"state": "UT",
"license": "10684127-4002",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Valley City, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.