Jaclyn Long, DPT

Primary specialty

Physical TherapistTaxonomy code 225100000X

License

11399812-2401 Issued in UT

Practice address

3540 S 4000 W Ste 340
West Valley City, UT 84120-3287

Phone

(801) 417-5017

Fax

(801) 417-5016

NPI assigned

Sep 10, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Specialty

Physical Therapist in Private Practice

Education

Other, 2019

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

Rocky Mountain Therapy ServicesGroup PAC ID 4486690559, 3 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Rocky Mountain Therapy Services

  • Physical Therapist
  • West Valley City, UT
  • NPI 1306864863
  Medicare reassignment Care Compare group NPD
• Rocky Mountain Therapy Services

  • Sports Physical Therapist
  • West Valley City, UT
  • NPI 1952637167
  Medicare reassignment NPD
• Rocky Mountain Therapy Services West Jordan LLC

  • Physical Therapist
  • West Jordan, UT
  • NPI 1013140011
  Medicare reassignment NPD

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

{
    "created_epoch": "1568073600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1568073600000",
    "number": "1841849916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 540640",
            "city": "NORTH SALT LAKE",
            "state": "UT",
            "postal_code": "840540640",
            "telephone_number": "801-987-8600"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3540 S 4000 W STE 340",
            "city": "WEST VALLEY CITY",
            "state": "UT",
            "postal_code": "841203287",
            "telephone_number": "801-417-5017",
            "fax_number": "801-417-5016"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LONG",
        "first_name": "JACLYN",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-09-10",
        "last_updated": "2019-09-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225100000X",
            "taxonomy_group": "",
            "desc": "Physical Therapist",
            "state": "UT",
            "license": "11399812-2401",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• David Timothy Lloyd, MS, CCC-SLP
• Jessica B Lloyd, MT-BC
• Mark Alan Lloyd, DDS
• Abraham James Lokey, DPT
• Dennis L Lombardi, M.D.
• Landen Longson
• John Howard Loomis III, D.O.
• Michelle Looye, LCSW
• Jacob Jesse Angle Lopez, M.A, CMHC
• Lotus Homehealth LLC

• Physical Therapist in West Valley City, UT
• Providers in West Valley City, UT by specialty
• Physical Therapist in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 10, 2019; 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.