Individual provider Active NPI

Lon Forsyth, OT

  • Occupational Therapist
  • Salt Lake City, UT
National Provider Identifier
1366074049
Registry record updated Jan 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11511332-4201 Issued in UT
Practice address
1050 E South Temple
Salt Lake City, UT 84102-1507
Phone
(801) 350-4113
NPI assigned
Feb 10, 2020
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11511332-4201 UT Primary

Addresses

Primary practice location

1050 E South Temple
Salt Lake City, UT 84102-1507

Mailing address

1050 E South Temple
Salt Lake City, UT 84102-1507
Phone (801) 350-4113

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address LFORSYTH340530@DIRECT.MED.UTAH.EDU Direct University of Utah

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20221222001100 UT Practitioner - Occupational Therapist in Private Practice 3274903869 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11511332-4201UTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
University of Utah Healthcare CurrentSince Sep 13, 2022 Accepting new patients
University of Utah Current Accepting new patients
University of Utah CurrentSince Sep 13, 2022 Accepting new patients

Locations

127 S 500 E
Ste 400B
Salt Lake City, UT 84102
Phone (801) 587-6478

50 N Medical Dr
Slc, UT 84132
Phone (801) 581-2292

Interoperability endpoints

  • Direct secure messaging: lforsyth340530@direct.med.utah.edu

Organizations & group practices 3

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1581292800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1673136000000",
    "number": "1366074049",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-350-4113"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1050 E SOUTH TEMPLE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021507",
            "telephone_number": "801-350-4113"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "LON",
        "credential": "OT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2020-02-10",
        "last_updated": "2023-01-08",
        "certification_date": "2023-01-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "11511332-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "LFORSYTH340530@DIRECT.MED.UTAH.EDU",
            "affiliation": "Y",
            "affiliationName": "University of Utah",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "CDA/CCD/TXT",
            "address_1": "50 N Medical Dr",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841320001",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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 Jan 8, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.