Individual provider Active NPI

Alex Broughton, DPT

  • Specialist
  • Springville, UT
National Provider Identifier
1043650047
Registry record updated May 19, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
SpecialistTaxonomy code 174400000X
License
7650433-2401 Issued in UT
Practice address
655 E 400 S
Springville, UT 84663-2027
Phone
(801) 704-9405
Fax
(801) 704-9407
NPI assigned
Jul 5, 2013
Last updated
May 19, 2015By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on May 19, 2015

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Specialist 174400000X 7650433-2401 UT Primary

Addresses

Primary practice location

655 E 400 S
Springville, UT 84663-2027

Mailing address

388 Eastview Dr
Alpine, UT 84004
Phone (801) 499-6560

Other identifiers 1

IdentifierTypeStateIssuer
7650433-2401OtherUTPHYSICAL THERAPIST

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in UT

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20150612000078 UT Practitioner - Physical Therapist in Private Practice 6709107782 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Physical Therapist in Private Practice
Education
Other, 2010
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

771 W 450
Suite a
Springville, UT 84663-2384
Phone (801) 704-9405

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
7650433-2401UTMDSpecialist

Practice roles

OrganizationSpecialtyStatusNew patients
Align Physical Therapy and Sports Medicine, LLC CurrentSince Apr 1, 2015 Accepting new patients
Walker Physical Therapy, Inc. PastSince Oct 1, 2003 Accepting new patients

Locations

655 E 400 S
Springville, UT 84663
Phone (801) 704-9405

771 W 450 S
Ste A
Springville, UT 84663
Phone (801) 704-9405

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, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1372982400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1431993600000",
    "number": "1043650047",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "388 EASTVIEW DR",
            "city": "ALPINE",
            "state": "UT",
            "postal_code": "84004",
            "telephone_number": "801-499-6560"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "655 E 400 S",
            "city": "SPRINGVILLE",
            "state": "UT",
            "postal_code": "846632027",
            "telephone_number": "801-704-9405",
            "fax_number": "801-704-9407"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROUGHTON",
        "first_name": "ALEX",
        "credential": "DPT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2013-07-05",
        "last_updated": "2015-05-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "",
            "desc": "Specialist",
            "state": "UT",
            "license": "7650433-2401",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PHYSICAL THERAPIST",
            "identifier": "7650433-2401",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Springville, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 19, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • 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.

Verify at the official NPI Registry.