Individual provider Active NPI

Mary Ann O Anderson, PT

  • Physical Therapist
  • SLC, UT
National Provider Identifier
1487748489
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
106548-2401 Issued in UT
Practice address
100 N Medical Dr
SLC, UT 84113-1103
Phone
(801) 588-2000
NPI assigned
Oct 3, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 8, 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 106548-2401 UT Primary

Addresses

Primary practice location

100 N Medical Dr
SLC, UT 84113-1103

Mailing address

100 N Medical Dr
SLC, UT 84113-1103
Phone (801) 588-2000

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
106548-2401UTMDPhysical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1159833600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1487748489",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-588-2000"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 N MEDICAL DR",
            "city": "SLC",
            "state": "UT",
            "postal_code": "841131103",
            "telephone_number": "801-588-2000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ANDERSON",
        "first_name": "MARY ANN",
        "middle_name": "O",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-10-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "106548-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in SLC, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.