Active NPI
Joel Mark Manwill, OT
- Occupational Therapist
- Layton, UT
National Provider Identifier
1750412193
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapist
- Practice address
- 3327 N 1050 E
Layton, UT 84040-6524 - Phone
- (801) 771-2073
- NPI assigned
- Mar 8, 2007
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pediatric Occupational Therapist | 225XP0200X | 314601-4201 | UT | |
| Occupational Therapist | 225X00000X | Primary |
Addresses
Primary practice location
3327 N 1050 E
Layton, UT 84040-6524
Mailing address
127 S. 500 E.
Suite 600
Salt Lake City, UT 84102-1971
Phone (801) 587-6336
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 999000021033 | Medicaid | UT |
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)
- Enrolled
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Pediatric Orthopedic Associates | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Pediatric Radiology Physician
- Salt Lake City, UT
- NPI 1659488799
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1173312000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1550188800000",
"number": "1750412193",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "127 S. 500 E.",
"address_2": "SUITE 600",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "841021971",
"telephone_number": "801-587-6336",
"fax_number": "801-715-8228"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3327 N 1050 E",
"city": "LAYTON",
"state": "UT",
"postal_code": "840406524",
"telephone_number": "801-771-2073"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MANWILL",
"first_name": "JOEL",
"middle_name": "MARK",
"credential": "OT",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-03-08",
"last_updated": "2019-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "225XP0200X",
"taxonomy_group": "",
"desc": "Occupational Therapist, Pediatrics",
"state": "UT",
"license": "314601-4201",
"primary": false
},
{
"code": "225X00000X",
"taxonomy_group": "",
"desc": "Occupational Therapist",
"state": null,
"license": null,
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "999000021033",
"state": "UT"
}
],
"endpoints": [],
"other_names": []
}Other providers in Layton, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 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.