Nicole Sobotka Bond, PT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

12373136-2401 Issued in UT

Practice address

1160 E 3900 S Ste 4000
Salt Lake City, UT 84124-1264

Phone

(385) 295-5087

Fax

(385) 295-4088

NPI assigned

Aug 6, 2014

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1407283200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692057600000",
    "number": "1275942062",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "684 N EAST CAPITOL BLVD",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032139",
            "telephone_number": "402-276-3958"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1160 E 3900 S STE 4000",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841241264",
            "telephone_number": "385-295-5087",
            "fax_number": "385-295-4088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BOND",
        "first_name": "NICOLE",
        "middle_name": "SOBOTKA",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-08-06",
        "last_updated": "2023-08-15",
        "certification_date": "2023-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "CO",
            "license": "0012836",
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12373136-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jaxon Thomas Bonanno
• Sandae Bonare, CNM
• Jake Bonasera
• Chelsea K Bond, LMT
• Melinda Bond
• Robert Edward Bond, M.D.
• Travis Bond, MD
• Jonathan David Bone, PSYD
• Kathleen Marie Bonebrake, MD
• Barrett Bonella, LCSW

• Physical Therapist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 15, 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.

Verify at the official NPI Registry.