Individual provider Active NPI

Amy K Fruge, DPT

  • Sports Physical Therapist
  • Salt Lake City, UT
National Provider Identifier
1831717610
Registry record updated Nov 27, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Sports Physical TherapistTaxonomy code 2251S0007X
License
11297887-2401 Issued in UT
Practice address
1760 S 1100 E Ste 3
Salt Lake City, UT 84105-3492
Phone
(832) 398-3146
NPI assigned
Jul 8, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Nov 27, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Sports Physical TherapistGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 2251S0007X 11297887-2401 UT Primary

Addresses

Primary practice location

1760 S 1100 E Ste 3
Salt Lake City, UT 84105-3492

Mailing address

1760 S 1100 E Ste 3
Salt Lake City, UT 84105-3492
Phone (832) 398-3146

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address amy@grassrootsphysicaltherapy.com

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

LicenseStateTypeSpecialty
11297887-2401UTMDSports Physical Therapist

NPI Registry JSON

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

{
    "created_epoch": "1594166400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701043200000",
    "number": "1831717610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1760 S 1100 E STE 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053492",
            "telephone_number": "832-398-3146"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1760 S 1100 E STE 3",
            "city": "SALT LAKE CITY",
            "state": "UT",
            "postal_code": "841053492",
            "telephone_number": "832-398-3146"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "FRUGE",
        "first_name": "AMY",
        "middle_name": "K",
        "credential": "DPT",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-07-08",
        "last_updated": "2023-11-27",
        "certification_date": "2020-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "2251S0007X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Physical Therapist, Sports",
            "state": "UT",
            "license": "11297887-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "amy@grassrootsphysicaltherapy.com",
            "affiliation": "Y",
            "address_1": "1760 S 1100 E Ste 3",
            "city": "Salt Lake City",
            "state": "UT",
            "country_code": "US",
            "postal_code": "841053492",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "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 Nov 27, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.