Active NPI
Bonnie Ross Butler, PT,OCS,CSCS
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1255332938
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 377196-2401
- 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
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 | 377196-2401 | 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 6
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 52947112802001 | Other | UT | BLUE CROSS BLUE SHIELD |
| 6400593 | Other | UT | UNITED HEALTHCARE |
| 5417 | Other | UT | DMBA |
| CJ9402 | Other | UT | RAILROAD MEDICARE |
| QM0000061055 | Other | UT | ALTIUS |
| 69157 | Other | UT | PEHP |
Other names 1
- Bonnie Ross Hensley
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)
- Enrolled
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": "1259625600000",
"number": "1255332938",
"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": "BUTLER",
"first_name": "BONNIE",
"middle_name": "ROSS",
"credential": "PT,OCS,CSCS",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2005-08-03",
"last_updated": "2009-12-01",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "377196-2401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "BLUE CROSS BLUE SHIELD",
"identifier": "52947112802001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UNITED HEALTHCARE",
"identifier": "6400593",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA",
"identifier": "5417",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "CJ9402",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000061055",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "69157",
"state": "UT"
}
],
"endpoints": [],
"other_names": [
{
"first_name": "BONNIE",
"last_name": "HENSLEY",
"middle_name": "ROSS",
"credential": "PT, OCS,CSCS",
"code": "1",
"type": "Former Name"
}
]
}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 Dec 1, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.