Individual provider Active NPI

Donna M Tiley, OTR L,CHT

  • Occupational Therapist
  • Salt Lake City, UT
National Provider Identifier
1194726786
Registry record updated Sep 16, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
5036567-4201 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
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 5036567-4201 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 9

IdentifierTypeStateIssuer
9733481002OtherUTCIGNA
CJ9402OtherUTRAILROAD MEDICARE
QM0000057787OtherUTALTIUS
870388269BR1OtherUTEDUCATORS MUTUAL
1108540001OtherUTCIGNA DMERC
68952OtherUTPEHP
50365674200001OtherUTBLUE CROSS BLUE SHIELD
5417OtherUTDMBA
09-00411OtherUTUNITED HEALTHCARE

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20040813000437 UT Practitioner - Occupational Therapist in Private Practice 7911970405 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Occupational Therapist in Private Practice
Education
Other, 1995
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Ihc Health Services IncGroup PAC ID 1850209420, 3,948 clinicians

Practice addresses (Care Compare)

900 Round Valley Dr
Park City, UT 84060-7552
Phone (435) 658-7377

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ihc Health Services, Inc. CurrentSince Sep 16, 2023 Accepting new patients
Ihc Health Services Inc CurrentSince Sep 16, 2023 Accepting new patients

Locations

380 E 1500 S
Ste 102
Heber City, UT 84032
Phone (435) 657-4690

900 Round Valley Dr
Park City, UT 84060
Phone (435) 658-7000

900 Round Valley Dr
Ste 1
Park City, UT 84060

5171 S Cottonwood St
Ste 900
Salt Lake City, UT 84107
Phone (801) 507-2050

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

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.

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": "1505520000000",
    "number": "1194726786",
    "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": "801-261-5942"
        },
        {
            "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": "TILEY",
        "first_name": "DONNA",
        "middle_name": "M",
        "credential": "OTR L,CHT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-08-03",
        "last_updated": "2017-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "5036567-4201",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "9733481002",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "CJ9402",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ALTIUS",
            "identifier": "QM0000057787",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EDUCATORS MUTUAL",
            "identifier": "870388269BR1",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA DMERC",
            "identifier": "1108540001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PEHP",
            "identifier": "68952",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS BLUE SHIELD",
            "identifier": "50365674200001",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "DMBA",
            "identifier": "5417",
            "state": "UT"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "UNITED HEALTHCARE",
            "identifier": "09-00411",
            "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 Sep 16, 2017; 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.