NPIMap

Organization Active NPI

Total Theta Wellness

  • Family Nurse Practitioner
  • Sandy, UT
National Provider Identifier
1699105338
Registry record updated Feb 19, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Family Nurse PractitionerTaxonomy code 363LF0000X
License
200020-4405 Issued in UT
Legal business name
TOTAL THETA WELLNESS
Practice address
8789 S Highland Dr
Suite 200
Sandy, UT 84093-1600
Phone
(801) 943-3373
Fax
(801) 943-0599
NPI assigned
Nov 15, 2013
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Feb 19, 2014

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

Authorized official

Name
Martha Southwick, FNP-BC
Title
Owner
Phone
(801) 943-3373

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Family Nurse PractitionerGroup: 193200000X MULTI-SPECIALTY GROUP 363LF0000X 200020-4405 UT Primary

Addresses

Primary practice location

8789 S Highland Dr
Suite 200
Sandy, UT 84093-1600

Mailing address

8789 S Highland Dr
Suite 200
Sandy, UT 84093-1600
Phone (801) 943-3373

National Provider Directory

National Provider Directory

Locations

8789 S Highland Dr
Ste 200
Sandy, UT 84093
Phone (801) 943-3373

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1384473600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1392768000000",
    "number": "1699105338",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8789 S HIGHLAND DR",
            "address_2": "SUITE 200",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931600",
            "telephone_number": "801-943-3373",
            "fax_number": "801-943-0599"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "8789 S HIGHLAND DR",
            "address_2": "SUITE 200",
            "city": "SANDY",
            "state": "UT",
            "postal_code": "840931600",
            "telephone_number": "801-943-3373",
            "fax_number": "801-943-0599"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "TOTAL THETA WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2013-11-15",
        "last_updated": "2014-02-19",
        "status": "A",
        "authorized_official_last_name": "SOUTHWICK",
        "authorized_official_first_name": "MARTHA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-943-3373",
        "authorized_official_credential": "FNP-BC"
    },
    "taxonomies": [
        {
            "code": "363LF0000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Nurse Practitioner, Family",
            "state": "UT",
            "license": "200020-4405",
            "primary": true
        }
    ],
    "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 Feb 19, 2014; 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.