NPIMap

Organization Active NPI

Mountain Land Sports & Orthopedic Physical Therapy of Santaquin LC

  • Physical Therapist
  • Santaquin, UT
National Provider Identifier
1356458467
Registry record updated Jul 3, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
Legal business name
MOUNTAIN LAND SPORTS & ORTHOPEDIC PHYSICAL THERAPY OF SANTAQUIN LC
Practice address
94 W Main St
Ste 1
Santaquin, UT 84655-7064
Phone
(801) 754-5700
Fax
(801) 942-5955
NPI assigned
Aug 24, 2006
Last updated
Jul 3, 2008By the provider in NPPES
Organization subpart
Yes
Parent organization
MOUNTAIN LAND REHABILITATION, INCAs reported in NPPES

NPPES NPI Registry

Updated by the provider on Jul 3, 2008

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

Authorized official

Name
Mr. Mark Anderson, PT
Title
President
Phone
(801) 942-3311

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU Primary
Occupational Therapist 225X00000X NU

Addresses

Primary practice location

94 W Main St
Ste 1
Santaquin, UT 84655-7064

Mailing address

PO Box 711185
Salt Lake City, UT 84171-1185
Phone (801) 942-3311

National Provider Directory

National Provider Directory
Part of
Mountain Land Rehabilitation LLC

Locations

94 W Main St
Ste 1
Santaquin, UT 84655
Phone (801) 754-5700

Practitioners & affiliated clinicians

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1156377600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1215043200000",
    "number": "1356458467",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841711185",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "94 W MAIN ST",
            "address_2": "STE 1",
            "city": "SANTAQUIN",
            "state": "UT",
            "postal_code": "846557064",
            "telephone_number": "801-754-5700",
            "fax_number": "801-942-5955"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MOUNTAIN LAND SPORTS & ORTHOPEDIC PHYSICAL THERAPY OF SANTAQUIN LC",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "MOUNTAIN LAND REHABILITATION, INC",
        "enumeration_date": "2006-08-24",
        "last_updated": "2008-07-03",
        "status": "A",
        "authorized_official_last_name": "ANDERSON",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "801-942-3311",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": true
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Santaquin, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 3, 2008; 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.