Active NPI
Maresa Madsen
- Physical Therapist
- Pleasant Grove, UT
National Provider Identifier
1740552959
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 8012349-2401
- Practice address
- 25 Alpine Ave
Pleasant Grove, UT 84062-3511 - Phone
- (801) 796-9821
- NPI assigned
- Feb 2, 2012
- Last updated
- Feb 7, 2012
- 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 | 8012349-2401 | UT | Primary |
Addresses
Primary practice location
25 Alpine Ave
Pleasant Grove, UT 84062-3511
Mailing address
1145 Meadow Fork Rd
#7
Provo, UT 84606-3613
Phone (714) 718-7668
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 |
|---|---|---|---|
| 8012349-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1328140800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1328572800000",
"number": "1740552959",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1145 MEADOW FORK RD",
"address_2": "#7",
"city": "PROVO",
"state": "UT",
"postal_code": "846063613",
"telephone_number": "714-718-7668"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "25 ALPINE AVE",
"city": "PLEASANT GROVE",
"state": "UT",
"postal_code": "840623511",
"telephone_number": "801-796-9821"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MADSEN",
"first_name": "MARESA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2012-02-02",
"last_updated": "2012-02-07",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "8012349-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Pleasant Grove, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 7, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.