Active NPI
Maryjane Alexis Miele, PT, DPT
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1124536560
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10474895-2401
- Practice address
- 30 N 1900 E
Som Ir73
Salt Lake City, UT 84132-0002 - Phone
- (801) 581-2733
- NPI assigned
- Jan 19, 2018
- 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 | 10474895-2401 | UT | Primary |
Addresses
Primary practice location
30 N 1900 E
Som Ir73
Salt Lake City, UT 84132-0002
Mailing address
160 S 600 E Apt 307
Salt Lake City, UT 84102-1963
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 10474895-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1516320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1516320000000",
"number": "1124536560",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "160 S 600 E APT 307",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021963"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "30 N 1900 E",
"address_2": "SOM IR73",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841320002",
"telephone_number": "801-581-2733"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MIELE",
"first_name": "MARYJANE",
"middle_name": "ALEXIS",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2018-01-19",
"last_updated": "2018-01-19",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "10474895-2401",
"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 Jan 19, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.