Jon Gabriel Osorio, PTA

Primary specialty

Physical Therapy AssistantTaxonomy code 225200000X

License

8334630-2402 Issued in UT

Practice address

2701 University Cirlce
Ogden, UT 84408-0001

Phone

(801) 626-7712

NPI assigned

Jun 5, 2018

Last updated

Jun 5, 2018By the provider in NPPES

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Sundance Physical Therapy LLC

  • Physical Therapist
  • Ogden, UT
  • NPI 1932265758
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1528156800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1528156800000",
    "number": "1013409093",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2496 N 400 W",
            "city": "SUNSET",
            "state": "UT",
            "postal_code": "840153416",
            "telephone_number": "801-860-3283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2701 UNIVERSITY CIRLCE",
            "city": "OGDEN",
            "state": "UT",
            "postal_code": "844080001",
            "telephone_number": "801-626-7712"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "OSORIO",
        "first_name": "JON",
        "middle_name": "GABRIEL",
        "credential": "PTA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-06-05",
        "last_updated": "2018-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "225200000X",
            "taxonomy_group": "",
            "desc": "Physical Therapy Assistant",
            "state": "UT",
            "license": "8334630-2402",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Douglas Orton, MD
• Luanne Orvis
• Milla Jane Osborne, L.P.C.
• Kalia Osmond
• Stuart W Osofsky, DDS
• Alma True Ott, N.D.
• Brittany Rayne Ovalle, LCSW
• Mona Darlene Oversteg, OTR
• Laura Mae Owen-Keirstead, LPC
• Shayanne Owens

• Physical Therapy Assistant in Ogden, UT
• Providers in Ogden, UT by specialty
• Physical Therapy Assistant in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.