Foothill Sports Medicine

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

FOOTHILL SPORTS MEDICINE

Practice address

2645 Parleys Way
Salt Lake City, UT 84109-1636

Phone

(801) 450-6427

Fax

(801) 484-2828

NPI assigned

Sep 21, 2007

Organization subpart

No

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

Authorized official

Name

Robert Daniel Cervantez

Title

Owner/Physical Therapy

Phone

(801) 450-6427

Specialties & licenses 1

Addresses

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

{
    "created_epoch": "1190332800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1190332800000",
    "number": "1407042583",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2645 PARLEYS WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091636",
            "telephone_number": "801-450-6427",
            "fax_number": "801-484-2828"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2645 PARLEYS WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841091636",
            "telephone_number": "801-450-6427",
            "fax_number": "801-484-2828"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FOOTHILL SPORTS MEDICINE",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-09-21",
        "last_updated": "2007-09-21",
        "status": "A",
        "authorized_official_last_name": "CERVANTEZ",
        "authorized_official_first_name": "ROBERT",
        "authorized_official_middle_name": "DANIEL",
        "authorized_official_title_or_position": "OWNER/PHYSICAL THERAPY",
        "authorized_official_telephone_number": "801-450-6427"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jeremy David Footer, LCSW
• Foothill Chiropractic, Inc
• Foothill Clinic, LLC
• Foothill Clinic, LLC
• Foothill Family Clinc Inc.
• Laurie M Forbes, MSW, CSW
• Matthew Forbes
• Ty Forbes
• Kyleigh Forbush
• Lauren Forbush, BEHAVIOR ANALYST

• All providers in Salt Lake City, UT
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 21, 2007; 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.