Active NPI
Haley Brock
- Occupational Therapist
- West Haven, UT
National Provider Identifier
1508623323
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- License
- 13708203-4201
- Practice address
- 2639 W 3520 S
West Haven, UT 84401-8529 - Phone
- (801) 732-5290
- NPI assigned
- Feb 28, 2024
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Occupational Therapist | 225X00000X | 13708203-4201 | UT | Primary |
Addresses
Primary practice location
2639 W 3520 S
West Haven, UT 84401-8529
Mailing address
66 E Dorchester Dr
Salt Lake City, UT 84103-2203
Phone (801) 884-9569
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
| License | State | Type | Specialty |
|---|---|---|---|
| 13708203-4201 | UT | MD | Occupational Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1709078400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1709078400000",
"number": "1508623323",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "66 E DORCHESTER DR",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841032203",
"telephone_number": "801-884-9569"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2639 W 3520 S",
"city": "WEST HAVEN",
"state": "UT",
"postal_code": "844018529",
"telephone_number": "801-732-5290"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BROCK",
"first_name": "HALEY",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-02-28",
"last_updated": "2024-02-28",
"certification_date": "2024-02-28",
"status": "A"
},
"taxonomies": [
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": "UT",
"license": "13708203-4201",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in West Haven, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 28, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.