Wesley Santillan Spargo, PT

Primary specialty

Sports Physical TherapistTaxonomy code 2251S0007X

License

12201338-2401 Issued in UT

Practice address

174 W 4250 S Apt 402
Murray, UT 84107-3231

Phone

(801) 666-0415

NPI assigned

Jun 2, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1622592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1622592000000",
    "number": "1356917090",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 W 4250 S APT 402",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841073231",
            "telephone_number": "801-666-0415"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 W 4250 S APT 402",
            "city": "MURRAY",
            "state": "UT",
            "postal_code": "841073231",
            "telephone_number": "801-666-0415"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SPARGO",
        "first_name": "WESLEY",
        "middle_name": "SANTILLAN",
        "name_prefix": "Mr.",
        "credential": "PT",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-02",
        "last_updated": "2021-06-02",
        "certification_date": "2021-06-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Sports",
            "state": "UT",
            "license": "12201338-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "wesley@physioeliteusa.com",
            "affiliation": "N",
            "endpointDescription": "Email address",
            "use": "DIRECT",
            "useDescription": "Direct",
            "address_1": "174 W 4250 S Apt 402",
            "city": "Murray",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841073231",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Sports Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2021; 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.