MRS. JACQLYN FITZGERALD OTTOSEN (NPI# 1598087462) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1598087462 |
| Entity Type | Individual |
| Full Name | MRS. JACQLYN FITZGERALD OTTOSEN |
| Credential | P.T. |
| Practice Address |
100 Mario Capecchi Dr Salt Lake City UT 84113-1103 |
| Practice Telephone | 8016624980 |
| Mailing Telephone | 8016624980 |
| Enumeration Date | 2010-02-19 |
| Last Update Date | 2010-02-19 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2251P0200X |
Physical Therapist Specialization: Pediatrics |
1208452401 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Street Address |
100 MARIO CAPECCHI DR |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84113-1103 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1033111810 | Andrew Gerald Smith | Legal Medicine | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2005-08-11 |
| 1235535485 | Ihc Health Services Inc | Clinic/Center | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-17 |
| 1508262833 | Aimee Brierley | Occupational Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-11-13 |
| 1801290986 | Jeffery Zobell | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-10-17 |
| 1336542778 | Bevan Jensen | Pharmacist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-09-30 |
| 1699183152 | Kristina Rogers | Dentist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-07-29 |
| 1548677297 | Stephanie Eva Wisniewski | Speech-Language Pathologist | 100 Mario Capecchi Dr, Primary Children's Rehab, Salt Lake City, UT 84113-1103 | 2014-07-15 |
| 1184044877 | Adam Wesley Dell | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-04-21 |
| 1225456718 | Bhanu Muniyappa | Pediatrics | 100 Mario Capecchi Dr, Pediatrics Residency Program, Salt Lake City, UT 84113-1103 | 2014-04-01 |
| 1265850952 | Kristina Gulliver | Pediatrics | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2014-03-31 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1386111060 | Melissa Marie Dixon | Psychologist | Primary Children's Hospital Outpatient Services, 81 South Mario Capecchi Drive, Salt Lake City, UT 84113 | 2018-10-31 |
| 1366965618 | Ashley Stuart | Psychologist | 44 North Mario Capecchi Drive, Salt Lake City, UT 84113 | 2017-07-19 |
| 1487945135 | Justin C Wheeler | Pediatrics | 81 N Mario Capecchi Dr Fl 4, Salt Lake City, UT 84113 | 2011-04-29 |
| 1154612117 | Dana Boucek | Pediatrics | 100 North Mario Capecchi Dr., Primary Children's, Salt Lake City, UT 84113 | 2011-04-26 |
| 1285959502 | Anna Katherine Eyre Ermarth | Pediatrics | 81 Mario Capecchi, Salt Lake City, UT 84113 | 2010-03-30 |
| 1457682072 | Elizabeth K Cho | Nurse Practitioner | 100 North Mario Cappechi Dr., Salt Lake City, UT 84113 | 2010-01-21 |
| 1528290848 | Nancy Crandell Brown | Nurse Practitioner | 100 North Mario Cappechi Drive, Salt Lake City, UT 84113 | 2009-08-20 |
| 1679708481 | Primary Children's Medical Center | General Acute Care Hospital | 100 No. Mario Capecchi Drive, Salt Lake, UT 84113 | 2009-05-22 |
| 1467697235 | Tara Hook | Physical Therapist | 100 North Mario Capecchi Dr, Salt Lake City, UT 84113 | 2008-12-09 |
| 1144474768 | Jennifer K Workman | Pediatrics | 100 N Mario Capecchi Drive, Pediatric Crtical Care, Primary Children's Hospital, Salt Lake City, UT 84113 | 2008-11-10 |
| Find all providers in zip 84113 | ||||
| Taxonomy Code | 2251P0200X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| Specialization | Pediatrics |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1629625488 | Renee Adele Hensiek | Physical Therapist | 100 Mario Capecchi Drive, Salt Lake City, UT 84113 | 2019-08-26 |
| 1114483914 | Kayla Marie Lee | Physical Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2019-02-16 |
| 1467927962 | Linda De La Torre-alva | Physical Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2018-10-10 |
| 1275055816 | Brandi Dohmen | Physical Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2017-07-14 |
| 1356888119 | Amy Shuckra | Physical Therapist | 1275 E Fairfax Rd, Salt Lake City, UT 84103-4324 | 2017-01-31 |
| 1710439096 | Candace Ann Mckinnon | Physical Therapist | 100 N Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2016-11-02 |
| 1518304948 | Rick Reigle | Physical Therapist | 100 Mario Capecchi Dr, Salt Lake City, UT 84113-1103 | 2013-05-24 |
| 1861571648 | Scott Michael Jerome | Physical Therapist | 44 N Medical Dr, Salt Lake City, UT 84113-1105 | 2006-11-03 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1962024943 | Roots Pediatric Therapy | Physical Therapist | 5976 Kingsford Ave, Park City, UT 84098-6315 | 2020-05-12 |
| 1578082954 | Ot Innovations, LLC | Physical Therapist | 365 W 1550 N Ste H, Layton, UT 84041-2279 | 2017-09-16 |
| 1053856229 | Bradford Scott Bentley Jr. | Physical Therapist | 3741 W 12600 S, Ste 100, Riverton, UT 84065 | 2016-12-27 |
| 1366588030 | Cathy G Hill | Physical Therapist | 520 Quail Ridge Dr, Washington, UT 84780-1454 | 2007-01-30 |
| 1669565131 | Theresa A Holden | Physical Therapist | 44 Medical Drive, Salt Lake, UT 84113 | 2006-10-02 |
| 1609408822 | Nicole Pasdera | Physical Therapist | 90 Albion Village Way, Sandy, UT 84070-4013 | 2020-02-05 |
| 1720578610 | Jane Campbell Swanson | Physical Therapist | 280 N Main St # 2, Bountiful, UT 84010-6136 | 2018-05-16 |
| 1285187617 | Kimberly Milam | Physical Therapist | 3845 W 4700 S, Second Floor, Taylorsville, UT 84129-3454 | 2016-08-02 |
| 1801279229 | Megan R Crawford | Physical Therapist | 280 N Main St # 2, Bountiful, UT 84010-6136 | 2015-07-02 |
| 1184983777 | James Foster Harvey | Physical Therapist | 331 N 400 W, Orem, UT 84057-1913 | 2012-05-16 |
| Find all providers with the same taxonomy | ||||
| City | SALT LAKE CITY |
| Zip Code | 84113 |
Please comment or provide details below to improve the information on MRS. JACQLYN FITZGERALD OTTOSEN.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.