Active NPI
Mary McNeily, PT
- Physical Therapist
- Sandy, UT
National Provider Identifier
1639508120
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 12287959-2401
- Practice address
- 9702 S Chylene Dr
Sandy, UT 84092-3559 - Phone
- (202) 276-5094
- NPI assigned
- Nov 5, 2013
- Last updated
- Dec 7, 2022
- 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 3
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 2305208357 | VA | |
| Physical Therapist | 225100000X | 12287959-2401 | UT | Primary |
| Physical Therapist | 225100000X | 070-020464 | IL |
Addresses
Primary practice location
9702 S Chylene Dr
Sandy, UT 84092-3559
Mailing address
9702 S Chylene Dr
Sandy, UT 84092-3559
Phone (202) 276-5094
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 |
|---|---|---|---|
| 070-020464 | IL | MD | Physical Therapist |
| 12287959-2401 | UT | MD | Physical Therapist |
| 2305208357 | VA | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383609600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1670371200000",
"number": "1639508120",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "9702 S CHYLENE DR",
"city": "SANDY",
"state": "UT",
"postal_code": "840923559",
"telephone_number": "202-276-5094"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "9702 S CHYLENE DR",
"city": "SANDY",
"state": "UT",
"postal_code": "840923559",
"telephone_number": "202-276-5094"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MCNEILY",
"first_name": "MARY",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2013-11-05",
"last_updated": "2022-12-07",
"certification_date": "2022-12-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "VA",
"license": "2305208357",
"primary": false
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "12287959-2401",
"primary": true
},
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "IL",
"license": "070-020464",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Sandy, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 7, 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.