Active NPI
Joshua Bryan Utay, CPO, LPO
- Prosthetist
- Dallas, TX
National Provider Identifier
1508343146
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Prosthetist
- License
- 1064
- Practice address
- 2222 Welborn St
Dallas, TX 75219-3924 - Phone
- (214) 559-5000
- NPI assigned
- Jul 26, 2018
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Orthotist | 222Z00000X | 1064 | TX | |
| Prosthetist | 224P00000X | 1064 | TX | Primary |
Addresses
Primary practice location
2222 Welborn St
Dallas, TX 75219-3924
Mailing address
2222 Welborn St
Dallas, TX 75219-3924
Phone (214) 559-5000
Other practice location 1
3800 Gaylord Pkwy Ste 850
Frisco, TX 75034-0248
Phone (214) 559-5000
Other practice location 2
5700 Dallas Pkwy
Frisco, TX 75034-9580
Phone (469) 515-7100
Other practice location 3
1 Baylor Plaza
Ms: BCM 115
Houston, TX 77030
Phone (713) 798-3098
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1064 | Other | TX | TEXAS DEPT. OF LICENSING AND REGULATION |
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 |
|---|---|---|---|
| 1064 | TX | MD | Orthotist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1532563200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1645660800000",
"number": "1508343146",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2222 WELBORN ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752193924",
"telephone_number": "214-559-5000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2222 WELBORN ST",
"city": "DALLAS",
"state": "TX",
"postal_code": "752193924",
"telephone_number": "214-559-5000"
}
],
"practiceLocations": [
{
"address_1": "3800 Gaylord Pkwy Ste 850",
"address_purpose": "LOCATION",
"city": "Frisco",
"state": "TX",
"postal_code": "750340248",
"country_code": "US",
"telephone_number": "214-559-5000",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "5700 Dallas Pkwy",
"address_purpose": "LOCATION",
"city": "Frisco",
"state": "TX",
"postal_code": "750349580",
"country_code": "US",
"telephone_number": "469-515-7100",
"country_name": "United States",
"address_type": "DOM"
},
{
"address_1": "1 Baylor Plaza",
"address_2": "MS: BCM 115",
"address_purpose": "LOCATION",
"city": "Houston",
"state": "TX",
"postal_code": "77030",
"country_code": "US",
"telephone_number": "713-798-3098",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "UTAY",
"first_name": "JOSHUA",
"middle_name": "BRYAN",
"name_prefix": "Mr.",
"credential": "CPO, LPO",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2018-07-26",
"last_updated": "2022-02-24",
"certification_date": "2022-02-24",
"status": "A"
},
"taxonomies": [
{
"code": "222Z00000X",
"taxonomy_group": "",
"desc": "Orthotist",
"state": "TX",
"license": "1064",
"primary": false
},
{
"code": "224P00000X",
"taxonomy_group": "",
"desc": "Prosthetist",
"state": "TX",
"license": "1064",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "TEXAS DEPT. OF LICENSING AND REGULATION",
"identifier": "1064",
"state": "TX"
}
],
"endpoints": [],
"other_names": []
}Other providers in Dallas, TX
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.