Active NPI
Lee Skinner, DPT
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1154706869
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 9463254-2401
- Practice address
- 590 Wakara Way
Salt Lake City, UT 84118 - Phone
- (801) 587-7109
- NPI assigned
- Jul 23, 2015
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | PTL.0013334 | CO | |
| Physical Therapist | 225100000X | 9463254-2401 | UT | Primary |
Addresses
Primary practice location
590 Wakara Way
Salt Lake City, UT 84118
Mailing address
127 S. 500 E.
Suite 600
Salt Lake City, UT 84102-1971
Phone (801) 587-6336
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| Direct Messaging Address | lskinner152589@direct.med.utah.edu | Direct | University of Utah |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in UT
Enrollment records 1
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| PTL.0013334 | CO | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| University of Utah | Current | Accepting new patients | |
| University of Utah | Current | Accepting new patients |
Locations
50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292
590 S Wakara Way
Slc, UT 84108
Phone (801) 587-7005
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.
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1588656870
-
- General Acute Care Hospital
- Salt Lake City, UT
- NPI 1699889576
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1437609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1636675200000",
"number": "1154706869",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 S. 500 E.",
"address_2": "SUITE 600",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021971",
"telephone_number": "801-587-6336",
"fax_number": "801-715-8228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 WAKARA WAY",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84118",
"telephone_number": "801-587-7109"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SKINNER",
"first_name": "LEE",
"name_prefix": "Dr.",
"credential": "DPT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2015-07-23",
"last_updated": "2021-11-12",
"certification_date": "2021-11-12",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "CO",
"license": "PTL.0013334",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "9463254-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "DIRECT",
"endpointTypeDescription": "Direct Messaging Address",
"endpoint": "lskinner152589@direct.med.utah.edu",
"affiliation": "Y",
"affiliationName": "University of Utah",
"use": "DIRECT",
"useDescription": "Direct",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "CDA/CCD/TXT",
"address_1": "50 N Medical Dr",
"city": "Salt Lake City",
"state": "UT",
"country_code": "US",
"postal_code": "841320100",
"country_name": "United States",
"address_type": "DOM"
}
],
"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 Nov 12, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.