Individual provider Active NPI

Ashley Park

  • Pediatric Nutrition Registered Dietitian
  • Salt Lake City, UT
National Provider Identifier
1255119012
Registry record updated Jul 28, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Nutrition Registered DietitianTaxonomy code 133VN1004X
License
14189727-4901 Issued in UT
Practice address
857 E 200 S
Salt Lake City, UT 84102-2317
Phone
(801) 487-3276
NPI assigned
Sep 21, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 28, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Pediatric Nutrition Registered Dietitian 133VN1004X 14189727-4901 UT Primary

Addresses

Primary practice location

857 E 200 S
Salt Lake City, UT 84102-2317

Mailing address

857 E 200 S
Salt Lake City, UT 84102-2317
Phone (801) 487-3276

Other practice location 1

81 N Mario Capecchi Dr
Salt Lake City, UT 84113-1125
Phone (801) 662-5325

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
14189727-4901UTMDPediatric Nutrition Registered Dietitian

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1695254400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1753660800000",
    "number": "1255119012",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "857 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022317",
            "telephone_number": "801-487-3276"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "857 E 200 S",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841022317",
            "telephone_number": "801-487-3276"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "81 N Mario Capecchi Dr",
            "address_purpose": "LOCATION",
            "city": "Salt Lake City",
            "state": "UT",
            "postal_code": "841131125",
            "country_code": "US",
            "telephone_number": "801-662-5325",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PARK",
        "first_name": "ASHLEY",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-09-21",
        "last_updated": "2025-07-28",
        "certification_date": "2025-07-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "133VN1004X",
            "taxonomy_group": "",
            "desc": "Dietitian, Registered, Nutrition, Pediatric",
            "state": "UT",
            "license": "14189727-4901",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Jul 28, 2025; 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.