Elite Physical Therapy and Wellness

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ELITE PHYSICAL THERAPY AND WELLNESS

Practice address

55 E 100 N Ste 201B
Logan, UT 84321-4648

Phone

(385) 595-8892

NPI assigned

Oct 16, 2024

Organization subpart

No

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

Authorized official

Name

Derek Pond, PTNPI 1104299858

Title

Owner

Phone

(801) 735-6759

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Derek Pond, DPT

  • Physical Therapist
  • Logan, UT
  • NPI 1104299858
  Medicare reassignment NPD Authorized official

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

{
    "created_epoch": "1729036800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1741737600000",
    "number": "1083434674",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 E 100 N STE 201B",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214648",
            "telephone_number": "385-595-8892"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 E 100 N STE 201B",
            "city": "LOGAN",
            "state": "UT",
            "postal_code": "843214648",
            "telephone_number": "385-595-8892"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "8831 S Redwood Rd Ste C3",
            "address_purpose": "LOCATION",
            "city": "West Jordan",
            "state": "UT",
            "postal_code": "840889265",
            "country_code": "US",
            "telephone_number": "385-595-8892",
            "fax_number": "385-331-7242",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "ELITE PHYSICAL THERAPY AND WELLNESS",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-10-16",
        "last_updated": "2025-03-12",
        "certification_date": "2025-03-12",
        "status": "A",
        "authorized_official_last_name": "POND",
        "authorized_official_first_name": "DEREK",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-735-6759",
        "authorized_official_credential": "PT"
    },
    "taxonomies": [
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marjorie Edwards, SLP
• Spencer Brock Egan
• Austin C Egbert, DPT, PT
• Kasey Egbert, DPT
• Elevated Perspective
• Madison Jo Elliott
• Candis Ann Ellis, CLC, CLE, CCCB
• Jeremy W Ellis, D.D.S.
• Kevin Mark Ellsworth, O.D.
• Anne W. Elsweiler

• Physical Therapy Clinic/Center in Logan, UT
• Providers in Logan, UT by specialty
• Physical Therapy Clinic/Center in Utah

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.