Individual provider Active NPI

Laura Heckroth

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1669885562
Registry record updated Sep 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
12882220-2401 Issued in UT
Practice address
990 W Bellwood LN
Salt Lake City, UT 84123-5435
Phone
(812) 350-2287
NPI assigned
Jun 9, 2014
Last updated
Sep 18, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 18, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X NU
Physical Therapist 225100000X 12882220-2401 UT Primary

Addresses

Primary practice location

990 W Bellwood LN
Salt Lake City, UT 84123-5435

Mailing address

2482 Douglas St
Salt Lake City, UT 84106
Phone (812) 350-2287

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20231207003762 UT Practitioner - Physical Therapist in Private Practice 3678791084 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Indiana University School of Medicine, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Luna Care Physical Therapy LLCGroup PAC ID 4880089275, 7 clinicians

Practice addresses (Care Compare)

Salt Lake City, UT 84101
Phone (866) 525-3175

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Select Rehabilitation, LLC Physical Therapist CurrentSince Sep 5, 2023 Accepting new patients
Utah Luna Care Physical Therapy LLC Physical Therapist CurrentSince Dec 5, 2025 Accepting new patients

Locations

1430 E 4500 S
Millcreek, UT 84117
Phone (801) 272-8000

159 W Broadway
Ste 200
Salt Lake City, UT 84101
Phone (404) 408-5442

Organizations & group practices 2

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

NPI Registry JSON

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

{
    "created_epoch": "1402272000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694995200000",
    "number": "1669885562",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2482 DOUGLAS ST",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "84106",
            "telephone_number": "812-350-2287"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "990 W BELLWOOD LN",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841235435",
            "telephone_number": "812-350-2287"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HECKROTH",
        "first_name": "LAURA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-06-09",
        "last_updated": "2023-09-18",
        "certification_date": "2023-09-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "12882220-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Salt Lake City, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 18, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.