Active NPI
Elizabeth Ann Jensen, PT
- Physical Therapist
- Provo, UT
National Provider Identifier
1639321540
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 373957-2401
- Practice address
- 1675 N Freedom Blvd
Building 10B
Provo, UT 84604-2540 - Phone
- (801) 885-7624
- NPI assigned
- Oct 22, 2008
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 373957-2401 | UT | Primary |
Addresses
Primary practice location
1675 N Freedom Blvd
Building 10B
Provo, UT 84604-2540
Mailing address
1675 N Freedom Blvd
Building 10B
Provo, UT 84604-2540
Phone (801) 885-7624
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 |
|---|---|---|---|
| 373957-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1224633600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1224633600000",
"number": "1639321540",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1675 N FREEDOM BLVD",
"address_2": "BUILDING 10B",
"city": "PROVO",
"state": "UT",
"postal_code": "846042540",
"telephone_number": "801-885-7624"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1675 N FREEDOM BLVD",
"address_2": "BUILDING 10B",
"city": "PROVO",
"state": "UT",
"postal_code": "846042540",
"telephone_number": "801-885-7624"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JENSEN",
"first_name": "ELIZABETH",
"middle_name": "ANN",
"name_prefix": "Mrs.",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2008-10-22",
"last_updated": "2008-10-22",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "373957-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Provo, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 22, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.