Active NPI
Melissa Marie Wall, COTA/L
- Occupational Therapy Assistant
- Highland, UT
National Provider Identifier
1821688037
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Occupational Therapy Assistant
- License
- 7367725-4202
- Practice address
- 5870 W 10400 N Ste C
Highland, UT 84003-9640 - Phone
- (801) 756-8900
- NPI assigned
- Jan 21, 2021
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Occupational Therapy Assistant | 224Z00000X | 7367725-4202 | UT | Primary |
Addresses
Primary practice location
5870 W 10400 N Ste C
Highland, UT 84003-9640
Mailing address
4909 S Atwood Blvd
Upstairs Unit
Murray, UT 84107
Phone (801) 698-7485
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| SOAP URL | Computer? |
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)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 7367725-4202 | UT | MD | Occupational Therapy Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1611187200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1611187200000",
"number": "1821688037",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4909 S ATWOOD BLVD",
"address_2": "UPSTAIRS UNIT",
"city": "MURRAY",
"state": "UT",
"postal_code": "84107",
"telephone_number": "801-698-7485"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5870 W 10400 N STE C",
"city": "HIGHLAND",
"state": "UT",
"postal_code": "840039640",
"telephone_number": "801-756-8900"
}
],
"practiceLocations": [],
"basic": {
"last_name": "WALL",
"first_name": "MELISSA",
"middle_name": "MARIE",
"credential": "COTA/L",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2021-01-21",
"last_updated": "2021-01-21",
"certification_date": "2021-01-21",
"status": "A"
},
"taxonomies": [
{
"code": "224Z00000X",
"taxonomy_group": "",
"desc": "Occupational Therapy Assistant",
"state": "UT",
"license": "7367725-4202",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "SOAP",
"endpointTypeDescription": "SOAP URL",
"endpoint": "Computer?",
"affiliation": "N",
"address_1": "5870 W 10400 N Ste C",
"city": "Highland",
"state": "UT",
"country_code": "US",
"postal_code": "840039640",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Highland, UT
- Utah Podiatric Physicians and Surgeons Group (Utah Musculoskeletal Specialists)
- Utah Podiatric Physicians and Surgeons Group LLC (Utah Musculoskeletal Specialists (UMS))
- Utah Spinal Works
- Nicholas Vanalfen, DDS
- Wal-Mart Stores, Inc (Vision Center 30-2511)
- Charles Wesley Walton, MD
- Warnock Premier Health
- Steven J Weaver, OD
- Karla Weisenburger
- Mark Weisenburger
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 21, 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.