Individual provider Active NPI

Susan Miller, PT

  • Physical Therapist
  • Layton, UT
National Provider Identifier
1760586283
Registry record updated Apr 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Physical TherapistTaxonomy code 225100000X
License
53276982401 Issued in UT
Practice address
3225 W Gordon Ave
3
Layton, UT 84041-6508
Phone
(801) 497-0800
Fax
(801) 497-0807
NPI assigned
Sep 13, 2006
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 24, 2009

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 53276982401 UT Primary

Addresses

Primary practice location

3225 W Gordon Ave
3
Layton, UT 84041-6508

Mailing address

PO Box 711185
Salt Lake City, UT 84171-1185
Phone (801) 942-3311

Other identifiers 1

IdentifierTypeStateIssuer
1760586283MedicaidUT

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20220105002764 UT Practitioner - Physical Therapist in Private Practice 7416348214 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2002
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Utah Physical Therapy, Inc.Group PAC ID 2163676735, 14 clinicians

Practice addresses (Care Compare)

35 W 50
Suite 100
Centerville, UT 84014-2376
Phone (801) 827-0202

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
53276982401UTMDPhysical Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
Utah Physical Therapy, Inc. Physical Therapist CurrentSince Oct 18, 2021 Accepting new patients
Mountain Land Rehabilitation LLC Physical Therapist PastSince Aug 1, 2025 Accepting new patients

Locations

35 W 50 S
Ste 100
Centerville, UT 84014
Phone (801) 827-0202

1741 N 2000 W
Ste 6
Farr West, UT 84404
Phone (801) 689-0200

5957 Fashion Point Dr
Ste 102
South Ogden, UT 84403
Phone (801) 827-0200

3476 W 4600 S
West Haven, UT 84401
Phone (801) 689-0200

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1158105600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1240531200000",
    "number": "1760586283",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 711185",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841711185",
            "telephone_number": "801-942-3311",
            "fax_number": "801-942-5955"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3225 W GORDON AVE",
            "address_2": "3",
            "city": "LAYTON",
            "state": "UT",
            "postal_code": "840416508",
            "telephone_number": "801-497-0800",
            "fax_number": "801-497-0807"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MILLER",
        "first_name": "SUSAN",
        "credential": "PT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2006-09-13",
        "last_updated": "2009-04-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "53276982401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "1760586283",
            "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 Apr 24, 2009; 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.