Active NPI
Brandon David Greenwood, PT
- Physical Therapist
- Logan, UT
National Provider Identifier
1013023522
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 5047921-2401
- Practice address
- 1400 N 500 E
Logan, UT 84341-2455 - Phone
- (435) 716-1000
- NPI assigned
- Aug 21, 2006
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Physical Therapist | 225100000X | 5047921-2401 | UT | Primary |
Addresses
Primary practice location
1400 N 500 E
Logan, UT 84341-2455
Mailing address
1400 N 500 E
Logan, UT 84341-2455
Phone (435) 716-1000
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
Care Compare profile
Medicare Care Compare- Specialty
- Physical Therapist in Private Practice
- Education
- Other, 2002
- Medicare assignment
- May accept Medicare assignment
Practice addresses (Care Compare)
PO Box
Suite 27128
Salt Lake City, UT 84127
PO Box
Suite 30180
Salt Lake City, UT 84130
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 5047921-2401 | UT | MD | Physical Therapist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1156118400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1013023522",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1400 N 500 E",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412455",
"telephone_number": "435-716-1000"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1400 N 500 E",
"city": "LOGAN",
"state": "UT",
"postal_code": "843412455",
"telephone_number": "435-716-1000"
}
],
"practiceLocations": [],
"basic": {
"last_name": "GREENWOOD",
"first_name": "BRANDON",
"middle_name": "DAVID",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2006-08-21",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "5047921-2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Logan, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.