Individual provider Active NPI

Pamela Hobbs Tiede

  • Speech-Language Pathologist
  • South Salt Lake, UT
National Provider Identifier
1831835537
Registry record updated May 6, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Speech-Language PathologistTaxonomy code 235Z00000X
License
113870-4102 Issued in UT
Practice address
2500 S State St
South Salt Lake, UT 84115-3164
Phone
(385) 646-5000
NPI assigned
May 6, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 6, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Speech-Language Pathologist 235Z00000X 113870-4102 UT Primary

Addresses

Primary practice location

2500 S State St
South Salt Lake, UT 84115-3164

Mailing address

5910 S Whitewater Cir
Holladay, UT 84121-1560
Phone (801) 598-3371

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
113870-4102UTMDSpeech-Language Pathologist

NPI Registry JSON

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

{
    "created_epoch": "1651795200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1651795200000",
    "number": "1831835537",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5910 S WHITEWATER CIR",
            "city": "HOLLADAY",
            "state": "UT",
            "postal_code": "841211560",
            "telephone_number": "801-598-3371"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2500 S STATE ST",
            "city": "SOUTH SALT LAKE",
            "state": "UT",
            "postal_code": "841153164",
            "telephone_number": "385-646-5000"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TIEDE",
        "first_name": "PAMELA",
        "middle_name": "HOBBS",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-05-06",
        "last_updated": "2022-05-06",
        "certification_date": "2022-05-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "235Z00000X",
            "taxonomy_group": "",
            "desc": "Speech-Language Pathologist",
            "state": "UT",
            "license": "113870-4102",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in South Salt Lake, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 6, 2022; 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.