Active NPI
Frederick L Hobusch, PT
- Physical Therapist
- Taylorsville, UT
National Provider Identifier
1366475337
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 1078932401
- Practice address
- 5547 S 4015 W
#7
Taylorsville, UT 84129-4429 - Phone
- (801) 967-6055
- Fax
- (801) 967-6934
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- No
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 | 1078932401 | UT | Primary |
Addresses
Primary practice location
5547 S 4015 W
#7
Taylorsville, UT 84129-4429
Mailing address
5547 S 4015 W
#7
Taylorsville, UT 84129-4437
Phone (801) 967-6055
Other identifiers 10
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 107000733102 | Other | UT | IHC |
| 1720 | Other | UT | PEHP |
| 283376 | Other | UT | DMBA |
| 650014593 | Other | UT | RAILROAD MEDICARE |
| 190100500 | Other | UT | OWCP |
| 6400182 | Other | UT | UHC |
| NO259 | Medicaid | UT | |
| 3363451001 | Other | UT | CIGNA |
| 42671 | Other | UT | FIRST HEALTH |
| QM0000076206 | Other | UT | ALTIUS |
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 1078932401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1312329600000",
"number": "1366475337",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5547 S 4015 W",
"address_2": "#7",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841294437",
"telephone_number": "801-967-6055",
"fax_number": "801-967-6934"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5547 S 4015 W",
"address_2": "#7",
"city": "TAYLORSVILLE",
"state": "UT",
"postal_code": "841294429",
"telephone_number": "801-967-6055",
"fax_number": "801-967-6934"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HOBUSCH",
"first_name": "FREDERICK",
"middle_name": "L",
"name_prefix": "Mr.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2011-08-03",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "1078932401",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "IHC",
"identifier": "107000733102",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PEHP",
"identifier": "1720",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "DMBA",
"identifier": "283376",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "RAILROAD MEDICARE",
"identifier": "650014593",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OWCP",
"identifier": "190100500",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "UHC",
"identifier": "6400182",
"state": "UT"
},
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "NO259",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "CIGNA",
"identifier": "3363451001",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "FIRST HEALTH",
"identifier": "42671",
"state": "UT"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "ALTIUS",
"identifier": "QM0000076206",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Taylorsville, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 3, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.