Individual provider Active NPI

Elizabeth Bird

  • Student in an Organized Health Care Education/Training Program
  • Sandy, UT
National Provider Identifier
1164888129
Registry record updated Jan 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X
Practice address
11075 S State St Ste 33
Sandy, UT 84070-5183
Phone
(801) 990-4300
Fax
(801) 967-2127
NPI assigned
Jan 6, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Athletic Trainer 2255A2300X AT5970 TX
Student in an Organized Health Care Education/Training Program 390200000X UT Primary

Addresses

Primary practice location

11075 S State St Ste 33
Sandy, UT 84070-5183

Mailing address

PO Box 330
Magna, UT 84044-0330
Phone (801) 990-4300

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

LicenseStateTypeSpecialty
AT5970TXMDAthletic Trainer

Practice roles

OrganizationSpecialtyStatusNew patients
Aspen Ridge Counseling LLC CurrentSince Jan 22, 2023 Accepting new patients

Locations

11075 S State St
Ste 33
Sandy, UT 84070
Phone (801) 572-5833

Organizations & group practices 1

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": "1452038400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1674000000000",
    "number": "1164888129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 330",
            "city": "MAGNA",
            "state": "UT",
            "postal_code": "840440330",
            "telephone_number": "801-990-4300",
            "fax_number": "801-967-2127"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11075 S STATE ST STE 33",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840705183",
            "telephone_number": "801-990-4300",
            "fax_number": "801-967-2127"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIRD",
        "first_name": "ELIZABETH",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-01-06",
        "last_updated": "2023-01-18",
        "certification_date": "2023-01-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "TX",
            "license": "AT5970",
            "primary": false
        },
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Sandy, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 18, 2023; 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.