NPIMap

Organization Active NPI

Little Squirts Therapy Services LLC

  • Pediatric Physical Therapist
  • Providence, UT
National Provider Identifier
1518654730
Registry record updated Feb 26, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Pediatric Physical TherapistTaxonomy code 2251P0200X
Legal business name
LITTLE SQUIRTS THERAPY SERVICES LLC
Practice address
169 N Gateway Dr Ste 210
Providence, UT 84332-9805
Phone
(435) 701-7010
Fax
(435) 701-7012
NPI assigned
Apr 18, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 26, 2024

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

Authorized official

Name
Melanie Payne
Title
Credentialing Manager
Phone
(435) 999-0912

Specialties & licenses 6

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 224Z00000X
Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225100000X
Pediatric Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251P0200X Primary
Physical Therapy AssistantGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225200000X
Occupational TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 225X00000X
Speech-Language PathologistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 235Z00000X

Addresses

Primary practice location

169 N Gateway Dr Ste 210
Providence, UT 84332-9805

Mailing address

1392 W 6500 S
Hyrum, UT 84319-7105
Phone (435) 999-0912

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20231116003727 UT Part B Supplier - Physical/Occupational Therapy Group in Private Practice 4981051620 Receives reassigned benefits from 3 practitioners
Practice locations: Providence, UT

National Provider Directory

National Provider Directory

Locations

169 N Gateway Dr
Ste 210
Providence, UT 84332
Phone (435) 701-7010

Practitioners & affiliated clinicians

Practitioners 6

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1681776000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1708905600000",
    "number": "1518654730",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1392 W 6500 S",
            "city": "HYRUM",
            "state": "UT",
            "postal_code": "843197105",
            "telephone_number": "435-999-0912"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "169 N GATEWAY DR STE 210",
            "city": "PROVIDENCE",
            "state": "UT",
            "postal_code": "843329805",
            "telephone_number": "435-701-7010",
            "fax_number": "435-701-7012"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LITTLE SQUIRTS THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-04-18",
        "last_updated": "2024-02-26",
        "certification_date": "2024-02-19",
        "status": "A",
        "authorized_official_last_name": "PAYNE",
        "authorized_official_first_name": "MELANIE",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "435-999-0912"
    },
    "taxonomies": [
        {
            "code": "224Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "2251P0200X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Pediatrics",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225200000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapy Assistant",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "225X00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Occupational Therapist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "235Z00000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Speech-Language Pathologist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Providence, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.