Michael Elliott, ATC

Primary specialty

Athletic TrainerTaxonomy code 2255A2300X

License

070202240 Issued in AZ

Practice address

1420 S 500 W
Salt Lake City, UT 84115-5149

Phone

(602) 999-7738

NPI assigned

Jun 22, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1624320000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1624320000000",
    "number": "1740859875",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1531 E KENSINGTON AVE",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841052803",
            "telephone_number": "602-999-7738"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 S 500 W",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841155149",
            "telephone_number": "602-999-7738"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "ELLIOTT",
        "first_name": "MICHAEL",
        "credential": "ATC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-22",
        "last_updated": "2021-06-22",
        "certification_date": "2021-06-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2255A2300X",
            "taxonomy_group": "",
            "desc": "Specialist/Technologist, Athletic Trainer",
            "state": "AZ",
            "license": "070202240",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "mike.elliott@utahjazz.com",
            "affiliation": "N",
            "endpointDescription": "email",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "1420 S 500 W",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841155149",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Clay Warren Elliott
• Elizabeth Anne Elliott, NNP
• Jana Elliott
• Karma-Jaya Elliott, MD
• Keith Elliott, MD
• Paul Elliott
• Richard Leroy Ellis II, DMD
• Richard Leroy Ellis III, DDS
• Abigail Claire Ellis, PT
• Chaston J Ellis, DO

• Athletic Trainer in Salt Lake City, UT
• Providers in Salt Lake City, UT by specialty
• Athletic Trainer in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 22, 2021; 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.