Individual provider Active NPI

Lisa Forsyth

  • Occupational Therapist
  • South Jordan, UT
National Provider Identifier
1760223937
Registry record updated Jun 3, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Occupational TherapistTaxonomy code 225X00000X
License
11658650-4201 Issued in UT
Practice address
11201 S Ropemaker Rd
South Jordan, UT 84095-5111
Phone
(801) 792-0653
NPI assigned
Jun 3, 2024
Last updated
Jun 3, 2024By the provider in NPPES
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jun 3, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Occupational Therapist 225X00000X 11658650-4201 UT Primary

Addresses

Primary practice location

11201 S Ropemaker Rd
South Jordan, UT 84095-5111

Mailing address

11201 S Ropemaker Rd
South Jordan, UT 84095-5111

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240710000138 UT Practitioner - Occupational Therapist in Private Practice 7810432283 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
11658650-4201UTMDOccupational Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Excel Rehab Therapy LLC CurrentSince Mar 1, 2025 Accepting new patients
David L Wetzel LLC CurrentSince Jun 14, 2024 Accepting new patients

Locations

10291 S 1300 E
Sandy, UT 84094
Phone (801) 557-2821

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1717372800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717372800000",
    "number": "1760223937",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11201 S ROPEMAKER RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955111"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11201 S ROPEMAKER RD",
            "city": "SOUTH JORDAN",
            "state": "UT",
            "postal_code": "840955111",
            "telephone_number": "801-792-0653"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FORSYTH",
        "first_name": "LISA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2024-06-03",
        "last_updated": "2024-06-03",
        "certification_date": "2024-06-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225X00000X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist",
            "state": "UT",
            "license": "11658650-4201",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Jordan, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.