Active NPI
Jackie Soto, PT, DPT
- Physical Therapist
- Provo, UT
National Provider Identifier
1205519196
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 13453257-2401
- Practice address
- 1825 S East Bay Blvd
Provo, UT 84606-5530 - Phone
- (303) 434-3770
- NPI assigned
- Aug 8, 2023
- 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 | 13453257-2401 | UT | Primary |
Addresses
Primary practice location
1825 S East Bay Blvd
Provo, UT 84606-5530
Mailing address
794 E 700 N
Spanish Fork, UT 84660-1646
Phone (303) 434-3770
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13453257-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1691452800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1691452800000",
"number": "1205519196",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "794 E 700 N",
"city": "SPANISH FORK",
"state": "UT",
"postal_code": "846601646",
"telephone_number": "303-434-3770"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1825 S EAST BAY BLVD",
"city": "PROVO",
"state": "UT",
"postal_code": "846065530",
"telephone_number": "303-434-3770"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SOTO",
"first_name": "JACKIE",
"credential": "PT, DPT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2023-08-08",
"last_updated": "2023-08-08",
"certification_date": "2023-08-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "13453257-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 8, 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.