Active NPI
Bradley D Benard, PT
- Physical Therapist
- Eden, UT
National Provider Identifier
1023019593
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Physical Therapist
- License
- 121252 2401
- Practice address
- 4920 E 2550 N
Unit C
Eden, UT 84310 - Phone
- (801) 745-3200
- NPI assigned
- Aug 9, 2005
- 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 | 121252 2401 | UT | Primary |
Addresses
Primary practice location
4920 E 2550 N
Unit C
Eden, UT 84310
Mailing address
1551 Renaissance Towne Dr
Ste 350
Bountiful, UT 84010-7667
Phone (801) 295-3553
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 121252 2401 | UT | MD | Physical Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Alta Therapies LC | Physical Therapist | Past | Accepting new patients |
| Performance West Physical Therapy | Physical Therapist | Past | Accepting new patients |
Organizations & group practices 2
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Physical Therapist
- Bountiful, UT
- NPI 1720148240
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1123545600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1783900800000",
"number": "1023019593",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1551 RENAISSANCE TOWNE DR",
"address_2": "STE 350",
"city": "BOUNTIFUL",
"state": "UT",
"postal_code": "840107667",
"telephone_number": "801-295-3553",
"fax_number": "801-295-3599"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "4920 E 2550 N",
"address_2": "UNIT C",
"city": "EDEN",
"state": "UT",
"postal_code": "84310",
"telephone_number": "801-745-3200"
}
],
"practiceLocations": [],
"basic": {
"last_name": "BENARD",
"first_name": "BRADLEY",
"middle_name": "D",
"credential": "PT",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2005-08-09",
"last_updated": "2026-07-13",
"status": "A"
},
"taxonomies": [
{
"code": "225100000X",
"taxonomy_group": "",
"desc": "Physical Therapist",
"state": "UT",
"license": "121252 2401",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Eden, UT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 13, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.