Orthopaedic Therapy and Sports Performance LLC

Primary specialty

Physical Therapy Clinic/CenterTaxonomy code 261QP2000X

Legal business name

ORTHOPAEDIC THERAPY AND SPORTS PERFORMANCE LLC

Practice address

1030 S Medical Dr
Ste B
Brigham City, UT 84302-0739

Phone

(435) 538-5111

Fax

(435) 723-9710

NPI assigned

May 25, 2011

Organization subpart

No

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

Authorized official

Name

Susan M Taylor

Title

Credentialing Rep

Phone

(801) 505-0821

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in UT

Enrollment records 1

Practitioners 4

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

• Robby Wayne Dilg, DPT

  • Physical Therapist
  • Brigham City, UT
  • NPI 1548148810
  Medicare reassignment Care Compare group NPD
• Travis Dell Felix, DPT

  • Physical Therapist
  • Brigham City, UT
  • NPI 1124388558
  Medicare reassignment Care Compare group NPD
• Alex Nelson Beecher, DPT

  • Physical Therapist
  • Layton, UT
  • NPI 1639755283
  Medicare reassignment NPD
• John Berryhill, RPT

  • Physical Therapist
  • Smithfield, UT
  • NPI 1396741989
  Medicare reassignment NPD

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

{
    "created_epoch": "1306281600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1485388800000",
    "number": "1104119957",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1030 S MEDICAL DR",
            "address_2": "STE B",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843020739",
            "telephone_number": "435-538-5111",
            "fax_number": "435-723-9710"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1030 S MEDICAL DR",
            "address_2": "STE B",
            "city": "BRIGHAM CITY",
            "state": "UT",
            "postal_code": "843020739",
            "telephone_number": "435-538-5111",
            "fax_number": "435-723-9710"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "ORTHOPAEDIC THERAPY AND SPORTS PERFORMANCE LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2011-05-25",
        "last_updated": "2017-01-26",
        "status": "A",
        "authorized_official_last_name": "TAYLOR",
        "authorized_official_first_name": "SUSAN",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "CREDENTIALING REP",
        "authorized_official_telephone_number": "801-505-0821"
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Specialist",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QP2000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Physical Therapy",
            "state": "UT",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PTAN",
            "identifier": "U000075442",
            "state": "UT"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Penny J Ogden, CRNA
• Analise Olpin
• Robert Olsen
• Aaron Michael Olson, D.D.S.
• Joseph C. Olson, O.D.
• Orthoutah, LLC
• Christy Annie Overson
• Clayton Pabst
• Saige M Palmer
• Jose Roman Pantoja

• Physical Therapy Clinic/Center in Brigham City, UT
• Providers in Brigham City, 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 Jan 26, 2017; 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.