Active NPI
Bronwyn Tayler Manning
- Athletic Trainer
- Ogden, UT
National Provider Identifier
1528774437
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Athletic Trainer
- Practice address
- 3992 Central Campus Drive Dept 3504
Ogden, UT 84408-0001 - Phone
- (801) 626-7656
- NPI assigned
- Jan 24, 2023
- 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Athletic Trainer | 2255A2300X | 14025062-4810 | UT | |
| Athletic Trainer | 2255A2300X | Primary |
Addresses
Primary practice location
3992 Central Campus Drive Dept 3504
Ogden, UT 84408-0001
Mailing address
4650 Harrison Boulevard Ogden
Ogden, UT 84403
Phone (801) 473-3010
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 |
|---|---|---|---|
| 14025062-4810 | UT | MD | Athletic Trainer |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1674518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1719446400000",
"number": "1528774437",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4650 HARRISON BOULEVARD OGDEN",
"city": "OGDEN",
"state": "UT",
"postal_code": "84403",
"telephone_number": "801-473-3010"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3992 CENTRAL CAMPUS DRIVE DEPT 3504",
"city": "OGDEN",
"state": "UT",
"postal_code": "844080001",
"telephone_number": "801-626-7656"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANNING",
"first_name": "BRONWYN",
"middle_name": "TAYLER",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2023-01-24",
"last_updated": "2024-06-27",
"certification_date": "2024-06-18",
"status": "A"
},
"taxonomies": [
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": "UT",
"license": "14025062-4810",
"primary": false
},
{
"code": "2255A2300X",
"taxonomy_group": "",
"desc": "Specialist/Technologist, Athletic Trainer",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Ogden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 27, 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.