BEVAN D BLAKE (NPI# 1114928868) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1114928868 |
| Entity Type | Individual |
| Full Name | BEVAN D BLAKE |
| Credential | PT, DPT |
| Practice Address |
370 E South Temple #250 Salt Lake City UT 84111-1206 |
| Practice Telephone | 8015122656 |
| Practice Fax Number | 8019060336 |
| Mailing Telephone | 8015122656 |
| Mailing Fax Number | 8019060336 |
| Enumeration Date | 2005-08-03 |
| Last Update Date | 2012-10-10 |
| Gender Code | M |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 225100000X | Physical Therapist | 344859-2401 | UT | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| UT | UNITED HEALTHCARE | 64-00731 | 01 |
| UT | PEHP | 68963 | 01 |
| UT | EDUCATORS MUTUAL | 870388269BR1 | 01 |
| UT | RAILROAD MEDICARE | CJ9402 | 01 |
| UT | BLUE CROSS BLUE SHIELD | 34485924000001 | 01 |
| UT | DMBA | 5417 | 01 |
| Street Address |
370 E SOUTH TEMPLE #250 |
| City | SALT LAKE CITY |
| State | UT |
| Zip Code | 84111-1206 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194270397 | Roxanna Martinez | Massage Therapist | 370 E South Temple, #100, Salt Lake City, UT 84111-1206 | 2016-08-18 |
| 1124485123 | Zachary Taylor | Chiropractor | 370 E South Temple, Suite 100, Salt Lake City, UT 84111-1206 | 2016-01-21 |
| 1952727018 | Auralcare Hearing Centers of America, LLC | Clinic/Center | 370 E South Temple, Suite 150, Salt Lake City, UT 84111-1206 | 2014-03-13 |
| 1871727404 | Dustin James Farris | Dentist | 370 E South Temple, 220, Salt Lake City, UT 84111-1206 | 2009-05-11 |
| 1447406061 | Lora Faith Wortman | Social Worker | 370 E South Temple, #550, Salt Lake City, UT 84111-1206 | 2008-08-14 |
| 1649436916 | Jonathan David Bone | Psychologist | 370 E South Temple, Suite 550, Salt Lake City, UT 84111-1206 | 2008-08-05 |
| 1275701054 | Ruth P. Manville, Lcsw, PC | Social Worker | 370 E South Temple, Suite #240, Salt Lake City, UT 84111-1206 | 2008-02-14 |
| 1538367883 | Daniel C Meeks | Dentist | 370 E South Temple, Salt Lake City, UT 84111-1206 | 2007-07-09 |
| 1023235033 | Ruth Pellett Manville | Counselor | 370 E South Temple, Suite #240, Salt Lake City, UT 84111-1206 | 2007-04-19 |
| 1083732051 | Adolescent, Child and Family Therapy Clinic, Inc | Clinical Nurse Specialist | 370 E South Temple, Ste 550, Salt Lake City, UT 84111-1206 | 2007-03-27 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1316551336 | Mary Ann Rush | Case Manager/Care Coordinator | 334 E. 100 S., Slc, UT 84111 | 2020-09-08 |
| 1790396554 | Stephanie G Mishenko | Military Health Care Provider | 344e 100s, Slc, UT 84111 | 2020-08-13 |
| 1386264802 | Mckensee M Carter | Case Manager/Care Coordinator | 334 E 100 S, Salt Lake City, UT 84111 | 2020-04-24 |
| 1316421761 | Community Health Centers, Inc. | Social Worker | 610 S 200 E Ste #b, Salt Lake City, UT 84111 | 2018-09-21 |
| 1528545506 | Lauren Brittney Harman | Case Manager/Care Coordinator | 344 E. 100 S., Salt Lake City, UT 84111 | 2018-07-23 |
| 1851896484 | Shivani Chowdhary | Dentist | 370 E South Temple Ste 350, Salt Lake City, UT 84111 | 2018-03-26 |
| 1801390661 | Jaylee Marie Watman | Case Manager/Care Coordinator | 344 E. 100 S. Ste 301, Salt Lake City, UT 84111 | 2018-03-19 |
| 1467963918 | Victoira Julia Graham | Case Management | 344 East 100 South Ste 301, Salt Lake City, UT 84111 | 2017-10-23 |
| 1750805404 | Kayla Hymas | Behavioral Analyst | 243 E. 400 S., Slc, UT 84111 | 2017-08-02 |
| 1134643224 | Julie Peaslee | Counselor | 275 E South Temple Ste 110, Salt Lake City, UT 84111 | 2017-07-31 |
| Find all providers in zip 84111 | ||||
| Taxonomy Code | 225100000X |
| Grouping | Respiratory, Developmental, Rehabilitative and Restorative Service Providers |
| Classification | Physical Therapist |
| (1) Physical therapists are health care professionals who evaluate and treat people with health problems resulting from injury or disease. PT’s assess joint motion, muscle strength and endurance, function of heart and lungs, and performance of activities required in daily living, among other responsibilities. Treatment includes therapeutic exercises, cardiovascular endurance training, and training in activities of daily living. (2) A physical therapist is a person qualified by an accredited program in physical therapy, licensed by the state, and practicing within the scope of that license. Physical therapists treat disease, injury, or loss of a bodily part by physical means, such as the application of light, heat, cold, water, electricity, massage and exercise. They develop treatment plans based upon each patient’s strengths, weaknesses, range of motion and ability to function. (3) A health professional who specializes in physical therapy- the health care field concerned primarily with the treatment of disorders with physical agents and methods, such as massage, manipulation, therapeutic exercises, cold, heat (including short-wave, microwave, and ultrasonic diathermy), hydrotherapy, electric stimulation and light to assist in rehabilitating patients and in restoring normal function after an illness or injury. |
| Notes: Source: (1) APTA Guidelines for Physical Therapy Claims Review, American Physical Therapy Association. (3) Lexikon: Dictionary of Health Care Terms, Organizations and Acronyms for the Era of Reform, Joint Commission on Accreditation of Healthcare Organizations, Oakbrook Terrace, IL: 1994, p. 612 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1619587672 | Anna Farrell | Physical Therapist | University of Utah Health 50 N Medical Drive, Salt Lake City, UT 84132-0001 | 2020-08-05 |
| 1609400936 | Vdcpt801 LLC | Physical Therapist | 1003 W Fremont Ave, Salt Lake City, UT 84104-2007 | 2020-02-25 |
| 1669002416 | Vibe Wellness LLC | Physical Therapist | 2263 E Murray Holladay Rd, Salt Lake City, UT 84117-5392 | 2020-01-21 |
| 1043869548 | Sarah Salazar | Physical Therapist | 5872 S 900 E Ste 150, Salt Lake City, UT 84121-1679 | 2019-09-06 |
| 1780246967 | Tyson Greenwood | Physical Therapist | 2200 E 3300 S, Salt Lake City, UT 84109-2635 | 2019-07-08 |
| 1154980852 | On The Go Physical Therapy LLC | Physical Therapist | 2507 S 300 W, Salt Lake City, UT 84115-2908 | 2019-06-07 |
| 1518431527 | Ashley Carmody Mwongela | Physical Therapist | 8th Avenue C St E, Salt Lake City, UT 84143-0001 | 2019-01-14 |
| 1063991982 | Madison Sanderson | Physical Therapist | 2295 S Foothill Dr Ste 1, Salt Lake City, UT 84109 | 2018-08-10 |
| 1215427711 | Lindsay Sullivan | Physical Therapist | 1121 E Brickyard Rd Apt 1803, Salt Lake City, UT 84106-2531 | 2018-05-10 |
| 1871013490 | Sarah Fallon | Physical Therapist | 1587 S Foothill Dr Apt 27, Salt Lake City, UT 84108-2757 | 2017-06-24 |
| Find all providers in SALT LAKE CITY | ||||
| City | SALT LAKE CITY |
| Zip Code | 84111 |
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| 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.