Active NPI
Gracelyn Estrada, LMT
- Legal Medicine
- Layton, UT
National Provider Identifier
1508305566
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Legal Medicine
- License
- 10149438-4701
- Practice address
- 955 S 225 E
Layton, UT 84041-4169 - Phone
- (385) 239-2472
- NPI assigned
- Feb 22, 2017
- Sex
- Female
- Sole proprietor
- Yes
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 |
|---|---|---|---|---|
| Legal Medicine | 173000000X | 10149438-4701 | UT | Primary |
Addresses
Primary practice location
955 S 225 E
Layton, UT 84041-4169
Mailing address
955 S 225 E
Layton, UT 84041-4169
Phone (385) 239-2472
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
| License | State | Type | Specialty |
|---|---|---|---|
| 10149438-4701 | UT | MD | Legal Medicine |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1487721600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1487721600000",
"number": "1508305566",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "955 S 225 E",
"city": "LAYTON",
"state": "UT",
"postal_code": "840414169",
"telephone_number": "385-239-2472"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "955 S 225 E",
"city": "LAYTON",
"state": "UT",
"postal_code": "840414169",
"telephone_number": "385-239-2472"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ESTRADA",
"first_name": "GRACELYN",
"credential": "LMT",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2017-02-22",
"last_updated": "2017-02-22",
"status": "A"
},
"taxonomies": [
{
"code": "173000000X",
"taxonomy_group": "",
"desc": "Legal Medicine",
"state": "UT",
"license": "10149438-4701",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2017; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.