Active NPI
Susanne Marie Ackroyd, PT
- Physical Therapist
- Salt Lake City, UT
National Provider Identifier
1962580308
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 50367062401
- Practice address
- 451 Bishop Federal Lane
St Josephs Villa
Salt Lake City, UT 84115 - Phone
- (801) 487-7557
- Fax
- (801) 468-6843
- NPI assigned
- Nov 2, 2006
- 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 |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 50367062401 | UT | Primary |
Addresses
Primary practice location
451 Bishop Federal Lane
St Josephs Villa
Salt Lake City, UT 84115
Mailing address
996 Olympus Park Drive
D203
Salt Lake City, UT 84117
Phone (801) 815-4920
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| D6333 | Medicaid | UT |
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 |
|---|---|---|---|
| 50367062401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162425600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1962580308",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "996 OLYMPUS PARK DRIVE",
"address_2": "D203",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84117",
"telephone_number": "801-815-4920"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "451 BISHOP FEDERAL LANE",
"address_2": "ST JOSEPHS VILLA",
"city": "SALT LAKE CITY",
"state": "UT",
"postal_code": "84115",
"telephone_number": "801-487-7557",
"fax_number": "801-468-6843"
}
],
"practiceLocations": [],
"basic": {
"last_name": "ACKROYD",
"first_name": "SUSANNE",
"middle_name": "MARIE",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2006-11-02",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "50367062401",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "D6333",
"state": "UT"
}
],
"endpoints": [],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.