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  7. NPI Record 1679677025

MR. BOHN RAY BALES PT
Complete NPI Record 1679677025
Physical Therapist in Salt Lake City, UT

NPI Status: Active since September 07, 2006

Contact Information

1952 EAST 7000 S
#100
SALT LAKE CITY, UT
ZIP 84121
Phone: (801) 942-3311
Fax: (801) 943-3989

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Table of Contents

  1. NPI
  2. Entity Type Code
  3. Provider Last Name Legal Name
  4. Provider First Name
  5. Provider Middle Name
  6. Provider Name Prefix Text
  7. Provider Credential Text
  8. Provider First Line Business Mailing Address
  9. Provider Business Mailing Address City Name
  10. Provider Business Mailing Address State Name
  11. Provider Business Mailing Address Postal Code
  12. Provider Business Mailing Address Country Code If outside U S
  13. Provider Business Mailing Address Telephone Number
  14. Provider Business Mailing Address Fax Number
  15. Provider First Line Business Practice Location Address
  16. Provider Second Line Business Practice Location Address
  17. Provider Business Practice Location Address City Name
  18. Provider Business Practice Location Address State Name
  19. Provider Business Practice Location Address Postal Code
  20. Provider Business Practice Location Address Country Code If outside U S
  21. Provider Business Practice Location Address Telephone Number
  22. Provider Business Practice Location Address Fax Number
  23. Provider Enumeration Date
  24. Last Update Date
  25. Provider Gender Code
  26. Healthcare Provider Taxonomy Code 1
  27. Provider License Number 1
  28. Provider License Number State Code 1
  29. Healthcare Provider Primary Taxonomy Switch 1
  30. Other Provider Identifier 1
  31. Other Provider Identifier Type Code 1
  32. Other Provider Identifier State 1
  33. Is Sole Proprietor

Complete NPI Dataset

This page represents the complete record for NPI 1679677025. You can access the complete dataset, including a full list of field names, along with their values, and definitions as recorded by the NPI registry. Each field in the NPI record is explained, highlighting its significance and the possible values it can hold.

NPI: 1679677025
Entity Type Code: 1
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
The last name of the provider. If the provider is an individual, this is the legal name.
Provider First Name: BOHN
The first name of the provider, if the provider is an individual.
Provider Middle Name: RAY
The middle name of the provider, if the provider is an individual.
Provider Name Prefix Text: MR.
The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
Provider Credential Text: PT
The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
Provider First Line Business Mailing Address: PO BOX 711185
The first line mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider first line location address’’.
Provider Business Mailing Address City Name: SALT LAKE CITY
The city name in the mailing address of the provider being identified.
Provider Business Mailing Address State Name: UT
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Provider Business Mailing Address Postal Code: 84171
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Provider Business Mailing Address Country Code If outside U S : US
The country code in the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address country code’’.
Provider Business Mailing Address Telephone Number: 8019423311
The telephone number associated with mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address telephone number’’.
Provider Business Mailing Address Fax Number: 8019433989
The fax number associated with the mailing address of the provider being identified. This data element may contain the same information as ‘‘Provider location address fax number’’.
Provider First Line Business Practice Location Address: 1952 EAST 7000 S
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 Second Line Business Practice Location Address: #100
The second 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: SALT LAKE CITY
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: 84121
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: 8019423311
The telephone number associated with the location address of the provider being identified.
Provider Business Practice Location Address Fax Number: 8019433989
The fax number associated with the location address of the provider being identified.
Provider Enumeration Date: 9/7/2006
The date the provider was assigned a unique identifier (assigned an NPI).
Last Update Date: 7/8/2007
The date that a record was last updated or changed.
Provider Gender Code: M
The code designating the provider’s gender if the provider is a person.
Healthcare Provider Taxonomy Code 1: 225100000X
Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
Provider License Number 1: 58161872401
The license number issued to the provider being identified. The NPS can accommodate multiple license numbers for multiple specialties and for multiple States. The NPS will associate this data element with ‘‘provider taxonomy code’’.
Provider License Number State Code 1: UT
The code representing the State that issued the license to the provider being identified. This field can accommodate multiple States. It is associated with ‘‘provider license number.
Healthcare Provider Primary Taxonomy Switch 1: Y
Other Provider Identifier 1: D6203
Additional number currently or formerly used as an identifier for the provider being identified. This data element will be captured from the NPI application/update form.
Other Provider Identifier Type Code 1: 05
Code indicating the type of identifier currently or formerly used by the provider being identified. The codes may reflect UPIN, NSC, OSCAR, DEA, Medicaid State or PIN identification numbers. This data element will be captured from the NPI application/update form.
Other Provider Identifier State 1: UT
Is Sole Proprietor: N
Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No