Individual provider Active NPI

Laura Elizabeth Wenger, DPT

  • Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1750720504
Registry record updated Jun 14, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
8587229-2401 Issued in UT
Practice address
590 S Wakara Way
Salt Lake City, UT 84108-1200
Phone
(801) 587-7109
NPI assigned
Jun 14, 2013
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 14, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Physical Therapist 225100000X 8587229-2401 UT Primary

Addresses

Primary practice location

590 S Wakara Way
Salt Lake City, UT 84108-1200

Mailing address

6215 Starview Dr
Park City, UT 84098-6112

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150710002269 CO Practitioner - Physical Therapist in Private Practice 2961714480 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Tomsic Physical Therapy IncGroup PAC ID 5698733145, 7 clinicians

Practice addresses (Care Compare)

575 Rivergate
Unit 97
Durango, CO 81301-7490
Phone (970) 259-0574

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
8587229-2401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Tomsic Physical Therapy, Inc. Physical Therapist CurrentSince Sep 29, 2014 Accepting new patients

Locations

575 Rivergate Ln
Unit 97
Durango, CO 81301
Phone (970) 259-0574

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.

NPI Registry JSON

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

{
    "created_epoch": "1371168000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371168000000",
    "number": "1750720504",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6215 STARVIEW DR",
            "city": "PARK CITY",
            "state": "UT",
            "postal_code": "840986112"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "590 S WAKARA WAY",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841081200",
            "telephone_number": "801-587-7109"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "WENGER",
        "first_name": "LAURA",
        "middle_name": "ELIZABETH",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2013-06-14",
        "last_updated": "2013-06-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "8587229-2401",
            "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 Jun 14, 2013; 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.