Individual provider Active NPI

Steven G Crandall, PT, DPT, OCS

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1154322816
Registry record updated Jan 4, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
118117-2401 Issued in UT
Practice address
5151 S 900 E
#100
Salt Lake City, UT 84117-6601
Phone
(801) 261-3321
Fax
(801) 261-5942
NPI assigned
Aug 3, 2005
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 4, 2011

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 118117-2401 UT Primary

Addresses

Primary practice location

5151 S 900 E
#100
Salt Lake City, UT 84117-6601

Mailing address

5151 S 900 E
#100
Salt Lake City, UT 84117-6657
Phone (801) 261-3321

Other identifiers 7

IdentifierTypeStateIssuer
5417OtherUTDMBA
870388269BR1OtherUTEDUCATORS MUTUAL
2738637001OtherUTCIGNA
65521OtherUTPEHP
CJ9402OtherUTRAILROAD MEDICARE
11811724000001OtherUTBLUE CROSS BLUE SHIELD
6400624OtherUTUNITED HEALTHCARE

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000387 UT Practitioner - Physical Therapist in Private Practice 1355314840 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 1988
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Hand and Orthopedic Rehabilitation Specialists PCGroup PAC ID 0547252207, 26 clinicians

Practice addresses (Care Compare)

11762 S State St
Suite 120
Draper, UT 84020-7158
Phone (801) 501-8359

5151 S 900
Suite 100
Murray, UT 84117-6658

5547 S 4015
Suite 7
Taylorsville, UT 84129-4429
Phone (801) 967-6055

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
118117-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Hand & Orthopedic Rehabilitation Specialists PC Physical Therapist Current Accepting new patients
Hand & Orthopedic Rehabilitation Specialists PC Physical Therapist CurrentSince Apr 1, 2001 Accepting new patients
Hand & Orthopedic Rehabilitation Specialists CurrentSince Apr 30, 2001 Accepting new patients
Hand & Orthopedic Rehabilitation Specialists PC Physical Therapist Past Accepting new patients

Locations

5151 S 900 E
Ste 100
Murray, UT 84117
Phone (801) 261-3321

Interoperability endpoints

  • Direct secure messaging: steven.crandall.1@16923.direct.athenahealth.com

Organizations & group practices 4

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.

NPI Registry JSON

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

{
    "created_epoch": "1123027200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1294099200000",
    "number": "1154322816",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5151 S 900 E",
            "address_2": "#100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841176657",
            "telephone_number": "801-261-3321",
            "fax_number": "801-261-5972"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5151 S 900 E",
            "address_2": "#100",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841176601",
            "telephone_number": "801-261-3321",
            "fax_number": "801-261-5942"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CRANDALL",
        "first_name": "STEVEN",
        "middle_name": "G",
        "credential": "PT, DPT, OCS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2005-08-03",
        "last_updated": "2011-01-04",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "118117-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "5417",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "870388269BR1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "2738637001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "65521",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ9402",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "11811724000001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "6400624",
            "state": "UT"
        }
    ],
    "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 4, 2011; 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.

Verify at the official NPI Registry.