NPI |
1558882407 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Entity Type Code |
1 |
The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number. |
Provider Last Name Legal Name |
HARRISON |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Name |
SARAH |
The last name of the provider. If the provider is an individual, this is the legal name. |
Provider First Line Business Practice Location Address |
6013 S REDWOOD RD |
The first line location address of the provider
being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box. |
Provider Business Practice Location Address City Name |
TAYLORSVILLE |
The city name in the location address of the provider being identified. |
Provider Business Practice Location Address State Name |
UT |
The State code in the location of the provider
being identified. |
Provider Business Practice Location Address Postal Code |
841235220 |
The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available. |
Provider Business Practice Location Address Country Code If outside U S |
US |
The country code in the location address of the provider being identified. |
Provider Business Practice Location Address Telephone Number |
8012555131 |
The telephone number associated with the location address of the provider being identified. |
Provider Business Practice Location Address Fax Number |
8012555131 |
The fax number associated with the location
address of the provider being identified. |
Provider Enumeration Date |
6/30/2017 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Last Update Date |
7/21/2022 |
The date the provider was assigned a unique identifier (assigned an NPI). |
Provider Gender Code |
F |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Taxonomy Code 1 |
101Y00000X |
The code designating the provider’s gender if the provider is a person. |
Healthcare Provider Primary Taxonomy Switch 1 |
Y |
|
Is Sole Proprietor |
Y |
|
Healthcare Provider Taxonomy Group 1 |
193200000X MULTI-SPECIALTY GROUP |
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