Julie L Waldo, MPT, OCS, CMPT

Primary specialty

SpecialistTaxonomy code 174400000X

License

344119-2401 Issued in UT

Practice address

150 S 600 E Ste 3B
Salt Lake City, UT 84102-1961

Phone

(801) 769-6778

Fax

(385) 202-7615

NPI assigned

Aug 21, 2006

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Other names 1

• Julie Lynn Thieszen Former name

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Body Tune Physical Therapy PC

  • Physical Therapist
  • South Ogden, UT
  • NPI 1952522419
  NPD (past)

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

{
    "created_epoch": "1156118400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1547164800000",
    "number": "1659486256",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "188 E ENSIGN VISTA DR",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841032260",
            "telephone_number": "801-769-6778",
            "fax_number": "385-202-7615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "150 S 600 E STE 3B",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841021961",
            "telephone_number": "801-769-6778",
            "fax_number": "385-202-7615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WALDO",
        "first_name": "JULIE",
        "middle_name": "L",
        "credential": "MPT, OCS, CMPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-08-21",
        "last_updated": "2019-01-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251X0800X",
            "taxonomy_group": "",
            "desc": "Physical Therapist, Orthopedic",
            "state": "UT",
            "license": null,
            "primary": false
        },
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "344119-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "JULIE",
            "last_name": "THIESZEN",
            "middle_name": "LYNN",
            "credential": "MPT, OCS, CMPT",
            "code": "1",
            "type": "Former Name"
        }
    ]
}

• Wal-Mart Stores, Inc
• Wal-Mart Stores, Inc
• Cheryl Ann Walczak, MD
• Hayley Jillian Waldbillig-Nelson
• Sharon J Waldman
• Jill Stratford Waldron, APRN, GNP-BC
• Matthew Christian Waldrop, PA-S
• Walgreen Co
• Walgreen Co
• Walgreen Co

• Specialist in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Specialist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 11, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.