Individual provider Active NPI

Emily Anderson

  • Recreation Therapist
  • Taylorsville, UT
National Provider Identifier
1245083849
Registry record updated Apr 11, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Recreation TherapistTaxonomy code 225800000X
License
12588235-4003 Issued in UT
Practice address
5472 S 3200 W
Taylorsville, UT 84129-7804
Phone
(801) 613-4600
NPI assigned
Apr 11, 2024
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 11, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Recreation Therapist 225800000X 12588235-4003 UT Primary

Addresses

Primary practice location

5472 S 3200 W
Taylorsville, UT 84129-7804

Mailing address

11433 S Jackson Downs Way
South Jordan, UT 84095-3427
Phone (801) 839-9621

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
12588235-4003UTMDRecreation Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Twin Peaks Medical P.C. PastSince Apr 14, 2024 Accepting new patients
Legacy Village Healthcare LLC PastSince Apr 14, 2024 Accepting new patients

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": "1712793600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1712793600000",
    "number": "1245083849",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11433 S JACKSON DOWNS WAY",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840953427",
            "telephone_number": "801-839-9621"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5472 S 3200 W",
            "city": "TAYLORSVILLE",
            "state": "UT",
            "postal_code": "841297804",
            "telephone_number": "801-613-4600"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "EMILY",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-04-11",
        "last_updated": "2024-04-11",
        "certification_date": "2024-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225800000X",
            "taxonomy_group": "",
            "desc": "Recreation Therapist",
            "state": "UT",
            "license": "12588235-4003",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Taylorsville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2024; 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.