Active NPI
Kristiann Henricksen, DPT
- Physical Therapist
- Price, UT
National Provider Identifier
1285142018
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 10630232-8016
- Practice address
- 284 N Hospital Dr
Price, UT 84501-4233 - Phone
- (435) 636-4841
- NPI assigned
- Jan 15, 2018
- Sex
- Female
- Sole proprietor
- Yes
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 | 10630232-8016 | UT | Primary |
Addresses
Primary practice location
284 N Hospital Dr
Price, UT 84501-4233
Mailing address
284 N Hospital Dr
Price, UT 84501-4233
Other names 1
- Kristiann Grange
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 |
|---|---|---|---|
| 10630232-8016 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1515974400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1515974400000",
"number": "1285142018",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "284 N HOSPITAL DR",
"city": "PRICE",
"state": "UT",
"postal_code": "845014233"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "284 N HOSPITAL DR",
"city": "PRICE",
"state": "UT",
"postal_code": "845014233",
"telephone_number": "435-636-4841"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HENRICKSEN",
"first_name": "KRISTIANN",
"credential": "DPT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-01-15",
"last_updated": "2018-01-15",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "10630232-8016",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": [
{
"first_name": "KRISTIANN",
"last_name": "GRANGE",
"code": "1",
"type": "Former Name"
}
]
}Other providers in Price, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 15, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.