NPIMap

Organization Active NPI

Fast Track Physical Therapy and Sports Medicine, PLLC

  • Physical Therapist
  • Midvale, UT
National Provider Identifier
1124263728
Registry record updated Jul 31, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
6006997-2401 Issued in UT
Legal business name
FAST TRACK PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC
Practice address
6717 South 900 East
Suite 201
Midvale, UT 84047
Phone
(801) 649-4690
Fax
(801) 984-4011
NPI assigned
Dec 10, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2009

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

Authorized official

Name
Dr. George A Shirley, PT, DPT, MS, ATC
Title
Physical Therapist/Owner
Phone
(801) 649-4690

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225100000X 6006997-2401 UT Primary

Addresses

Primary practice location

6717 South 900 East
Suite 201
Midvale, UT 84047

Mailing address

6717 South 900 East
Suite 201
Midvale, UT 84047
Phone (801) 649-4690

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1228867200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1248998400000",
    "number": "1124263728",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6717 SOUTH 900 EAST",
            "address_2": "SUITE 201",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-649-4690",
            "fax_number": "801-984-4011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6717 SOUTH 900 EAST",
            "address_2": "SUITE 201",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "84047",
            "telephone_number": "801-649-4690",
            "fax_number": "801-984-4011"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAST TRACK PHYSICAL THERAPY AND SPORTS MEDICINE, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-10",
        "last_updated": "2009-07-31",
        "status": "A",
        "authorized_official_last_name": "SHIRLEY",
        "authorized_official_first_name": "GEORGE",
        "authorized_official_middle_name": "A",
        "authorized_official_title_or_position": "PHYSICAL THERAPIST/OWNER",
        "authorized_official_telephone_number": "801-649-4690",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PT, DPT, MS, ATC"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "6006997-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2009; 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.