ORTHOPAEDIC THERAPY AND SPORTS PERFORMANCE LLC (NPI# 1104119957) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1104119957 |
| Entity Type | Organization |
| Organization Name | ORTHOPAEDIC THERAPY AND SPORTS PERFORMANCE LLC |
| Practice Address |
1030 S Medical Dr Ste B Brigham City UT 84302-0739 |
| Practice Telephone | 4355385111 |
| Practice Fax Number | 4357239710 |
| Mailing Telephone | 4355385111 |
| Mailing Fax Number | 4357239710 |
| Enumeration Date | 2011-05-25 |
| Last Update Date | 2017-01-26 |
| Authorized Official Name | SUSAN M TAYLOR (CREDENTIALING REP) |
| Authorized Official Telephone | 8015050821 |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 174400000X | Specialist | Other Service Providers | ||
| Y | 261QP2000X |
Clinic/Center Specialization: Physical Therapy |
UT | Ambulatory Health Care Facilities |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | PTAN | U000075442 | 01 |
| Street Address |
1030 S MEDICAL DR STE B |
| City | BRIGHAM CITY |
| State | UT |
| Zip Code | 84302-0739 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1669945531 | Brandon Lee Allen | Counselor | 971 South 800 West, #104, Brigham City, UT 84302 | 2019-01-03 |
| 1104307495 | Tiffany Burnhope | Social Worker | 663 Parker Lane, Brigham City, UT 84302 | 2018-08-24 |
| 1558858464 | Michael Clark | Optometrist | 990 Medical Dr Ste G3, Brigham City, UT 84302 | 2018-04-16 |
| 1497273130 | Emily Marler | Counselor | 862 South Main Suite 4, Brigham City, UT 84302 | 2017-09-01 |
| 1003268731 | Tyler Beckstrand | Social Worker | 125 N Main Street, Brigham City, UT 84302 | 2016-07-06 |
| 1780030155 | Angela Stott | Case Manager/Care Coordinator | 160 E 800 S Apt. B216, Brigham City, UT 84302 | 2016-05-04 |
| 1699156802 | Christopher Jacobson | Family Medicine | 1050 Medical Dr, Brigham City, UT 84302 | 2015-06-12 |
| 1811377765 | Courtney Allred | Counselor | 863 S Main Street Suite 2, Brigham, UT 84302 | 2015-06-05 |
| 1235529579 | Belinda Castro | Counselor | 862 S Main Street Suite 2, Brigham City, UT 84302 | 2015-01-26 |
| 1760871818 | Ambryn Mccallson | Counselor | 862 S. Main, 4, Brigham City, UT 84302 | 2015-01-13 |
| Find all providers in zip 84302 | ||||
| Taxonomy Code | 261QP2000X |
| Grouping | Ambulatory Health Care Facilities |
| Classification | Clinic/Center |
| Specialization | Physical Therapy |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1396344198 | Shannon Ballinger | Clinic/Center | 1470 400 W, Salt Lake City, UT 84115 | 2020-10-22 |
| 1487261707 | Precision Jointcare LLC | Clinic/Center | 12523 S Creek Meadow Rd Ste 109, Riverton, UT 84065-7299 | 2020-09-30 |
| 1184231664 | Mountain Strong Spine and Performance | Clinic/Center | 1478 N 4925 W, Plain City, UT 84404-8300 | 2020-09-28 |
| 1881215085 | Move Well Age Well, LLC | Clinic/Center | 2223 S Highland Dr Ste E6-256, Salt Lake City, UT 84106-3672 | 2020-04-29 |
| 1215557434 | Basin Therapy LLC | Clinic/Center | 101 E 1875 S, Roosevelt, UT 84066-3828 | 2020-04-17 |
| 1780222893 | Well Being Pelvic Physical Therapy | Clinic/Center | 111 E 5600 S Ste 222, Murray, UT 84107-8164 | 2019-12-19 |
| 1265094619 | Recalibrate Physical Therapy | Clinic/Center | 3450 S 400 E, Salt Lake City, UT 84115-4604 | 2019-07-06 |
| 1598229155 | Neurorev Pllc | Clinic/Center | 520 N Market Place Dr Ste 200, Centerville, UT 84014-4904 | 2019-01-29 |
| 1104395821 | Color Country Physical Therapy LLC | Clinic/Center | 450 E Clinic Way, Ste B, Parowan, UT 84761 | 2018-11-26 |
| 1629556055 | Advanced Balance and Physical Therapy LLC | Clinic/Center | 856 Sage Dr Ste 301b, Cedar City, UT 84720 | 2018-07-28 |
| Find all providers with the same taxonomy | ||||
| City | BRIGHAM CITY |
| Zip Code | 84302 |
Please comment or provide details below to improve the information on ORTHOPAEDIC THERAPY AND SPORTS PERFORMANCE LLC.
| 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.