Individual provider Active NPI

Elizabeth A Rupert, MPT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1477522522
Registry record updated Sep 17, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
PT017361 Issued in PA
Practice address
6440 South Millrock Drive
Suite 175
Salt Lake City, UT 84121
Phone
(866) 661-0984
Fax
(866) 588-1518
NPI assigned
Mar 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X PT017361 PA Primary

Addresses

Primary practice location

6440 South Millrock Drive
Suite 175
Salt Lake City, UT 84121

Mailing address

PO Box 713600
Salt Lake City, UT 84171-3600
Phone (866) 661-0984

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

LicenseStateTypeSpecialty
PT017361PAMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Carolina Sportscare and Physical Therapy Physical Therapist PastSince Jan 28, 2002 Accepting new patients
East Suburban Home Care LLC Physical Therapist Past Accepting new patients

Organizations & group practices 2

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": "1142294400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1189987200000",
    "number": "1477522522",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 713600",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841713600",
            "telephone_number": "866-661-0984",
            "fax_number": "866-588-1518"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6440 SOUTH MILLROCK DRIVE",
            "address_2": "SUITE 175",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84121",
            "telephone_number": "866-661-0984",
            "fax_number": "866-588-1518"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RUPERT",
        "first_name": "ELIZABETH",
        "middle_name": "A",
        "credential": "MPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-03-14",
        "last_updated": "2007-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "PA",
            "license": "PT017361",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "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 Sep 17, 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.